These days more and more people are aware that when a couple experiences problems with fertility, it’s equally likely to be an issue with the male or female partner. In fact, 30% of all cases of infertility come down to male factors, 30% female, with the remainder unexplained. Naturally, if you’ve been trying for a baby for a year (or six months if the female partner is over 35) your first step will be to get some fertility testing done for both of you.
For men, the most common causes of infertility include damage or alterations around the testicular area, ejaculation or erectile problems, diseases of the prostate or tubal obstruction, or alterations in the semen. Genetic and hormonal factors can also have an impact. Of all the various fertility tests for men, a semen analysis is the most obvious starting point.
Fertility tests for men: semen analysis
A semen analysis is not only the simplest fertility test for men, but also crucial for another reason. A woman’s eggs are present at birth and deteriorate more because of age than any lifestyle factors. However, semen is constantly being produced in the male body. Lifestyle improvements, where the need for them is identified, can improve the quality and quantity of sperm. It is therefore well worth while finding out as soon as possible whether this is the case for you. Semen analysis tests for different aspects of your fertility potential:
Also known as sperm concentration, this is the measure of how many sperm are present per millilitre of semen. A normal sperm count is anywhere from 15 million to 200 million per millilitre. Anything below this range is considered low.
Motility relates to how well sperm can move and propel themselves towards the egg. A normal motility would mean at least 40% of the sperm having some movement. Of these, 32% would be able to propel themselves in a straight line or large sweeping circle.
This is about the shape and structure of the sperm. It is the measure of the proportion of a sperm sample with the optimum shape, structure and size. Many do not meet the criteria, but you only need a minimum of 4% of a sample to have the ideal morphology to be considered normal.
The amount of semen per ejaculate can also have an impact on male fertility. Less than 1.5 millilitres is considered low. A low volume does not necessarily reduce fertility by itself, but it could indicate an obstruction in the system or infection of the testicles.
A semen analysis is usually carried out by a urology office or a fertility clinic, but you could opt for a home test. Some people do this to avoid the slight awkwardness of needing to produce a sample in a doctor’s office. However, you need to be aware that these home tests normally only report on your sperm count. This is useful information, but as we have seen above, is only a part of the full picture that’s needed for an accurate assessment.
Advanced fertility tests for men
A semen analysis will certainly help your doctor to understand whether you have a problem with fertility. There are still other fertility tests for men which can build up an even more accurate picture. These include a physical medical examination, hormone and genetic testing, a testicular biopsy and other specialised investigations of sperm function.
- A physical examination could detect the presence of varicoceles. These are veins in the scrotum which become abnormally dilated. They are quite common and not dangerous, with around 15% of adult men having them. They do not usually cause any problems but can impair fertility or cause a complete lack of sperm in the semen. In these cases, they can be repaired surgically.
- Scrotal and transrectal ultrasound could also be used as part of the physical examination to help your doctor to identify any blockages or malformations of the vas deferens. If identified, these could be corrected with surgery.
- Hormone testing can be done by means of a simple blood test. This will show levels of testosterone, follicle stimulating hormone and luteinising hormone. All of these are important in the production of sperm.
- The development of in vitro fertilisation (IVF) has enabled major advances in genetic testing in relation to infertility. A genetic test, carried out via a blood sample, can identify whether changes in the Y chromosome may be causing an extremely low concentration of sperm.
- A testicular biopsy involves the removal of a tissue sample from the testicles via a needle. This can be a useful diagnostic test. For example, if the biopsy showed that your sperm production is normal, it would indicate the probability of a blockage obstructing the transport of sperm.
- Other specialised tests can check for sperm function, for example how successful they are at surviving following ejaculation and their ability to attach to and penetrate an egg.
You won’t necessarily need most of these tests. The fertility specialist will only recommend those that are needed for a diagnosis in your case. The good news is that in most cases, there is a fertility treatment that can help you to have that longed-for first child or grow your family.
What are my options for assisted fertility treatment?
The most recommended fertility treatments for men include:
- IVF, which could be recommended for couples where moderate or severe male factor infertility results from poor sperm quality. The use of IVF allows for sperm washing if there is a need to avoid sexual transmission disease (STDs), and for preparation and selection of only the healthiest sperm to be used for egg fertilisation.
- Intracytoplasmic Sperm Injection (ICSI) is a technique associated with IVF. If necessary, sperm can be extracted via testicular biopsy, prepared in the laboratory so that the best sperm are selected, and then a single sperm is micro-injected into each egg to give the best chance of conception.
- Sperm donation may be the treatment of choice for some patients. These include where the male partner has a complete absence of sperm or in other cases, for example, where the man is a carrier of a genetic disease which is undetectable in the embryo.
Next steps: contacting IVI
Whatever the reason for your infertility, there is almost always help available. You can take the first step towards finding a solution by getting in touch with us at IVI. Just use our online contact form, then we’ll get back to you and together we can take it from there.