If you and your partner are finding it difficult to get pregnant, there’s about a 40 percent chance that the male partner is at least part of the problem. This is a touchy subject for most men, but it is more common than you might think. That’s why infertility specialists test for male factor infertility.
A physical exam and the male partner’s medical history contribute to the diagnosis and fertility treatment options. Also, there are preliminary tests which are important in figuring out if there is an issue and how to treat it.
A Little Male Biology
The man’s job in conception is to “plant the seed,” i.e., get his sperm to the female partner’s egg. This involves being able to have an erection, have intercourse, and send his sperm into his partner’s vagina. The physical exam and his medical history will help his doctor determine if there are problems in this area.
Some of the major problems with male fertility are related to the sperm. Sperm may be produced in low numbers (low sperm count). They may not swim well enough to catch up to the egg (low motility.) Or the sperm may not have a normal shape (abnormal morphology), so they are unable to penetrate and fertilize the egg.
Usually the first test performed on the male partner, semen analysis, measures the quality and quantity of both the semen, which carries the sperm, and the sperm itself. Some of the things the test measures are volume of semen (how much), sperm count, concentration of sperm in the semen, percentage of the sperm that are moving, and if the sperm are the right shape or not, according to the American Society of Reproductive Medicine.
The man provides the sample at the doctor’s office or by using a special condom at home. However, the sample has to be tested within an hour of being collected. Often men have to provide two samples on different days more than two weeks apart, because sperm production can vary from day to day.
Blood Tests for Hormones
Hormones, which are chemicals produced by your body, control sperm production. Too much or too little of certain hormones can cause fertility problems or problems with having sex. Your doctor may ask for blood tests to measure follicle stimulating hormone (FSH), testosterone, and other hormones such as luteinizing hormone (LH), estradiol, and prolactin.
Tests for Infections and Immune System Issues
If the semen analysis shows sperm clumping or signs of infection, your doctor may order other tests such as semen culture, prostate fluid analysis, and urinalysis. Another potential problem is when the male partner’s body develops antibodies to his sperm. Your doctor may order an antisperm antibody test.
In some cases the doctor will order a “fructose test,” which helps determine if there is a blockage in the tubes that carry the sperm out to be ejaculated (seminal vesicles) or the ducts.
What Happens Next?
Even if the test results show problems with the sperm or structural disorders, there are fertility treatments which may be able to help. There are a range of solutions depending on the issues, from surgery for a structural problem, to artificial insemination, or IVF with ICSI—in vitro fertilization with intracytoplasmic sperm injection, which injects a single sperm into the egg in the embryology lab.
Don’t panic! Take the process one step at a time. You can get the treatment you need as a couple, and infertility treatment cost may be more affordable than you think, and there are financing programs available.