When you’ve tried for twelve consecutive months to conceive and haven’t had success (or 6 months for women over 35) it’s time for an evaluation of your fertility. While some people still think of infertility as solely a women’s issue, male factor infertility is nearly as common as female factor infertility.
Infertility impacts the lives of one out of every six couples. Male factor infertility alone figures in 30% of those cases, yet it’s often misunderstood. Very often the first symptom of male factor infertility is the inability to conceive.
As a couple suspects something might be amiss they schedule an appointment with their doctor for an evaluation. Both partners undergo a physical exam and provide a health history to rule out any underlying conditions and test for a possible genetic link.
6 Common Tests to Diagnose Infertility in Men
Your doctor goes over your list of medications and any other supplements you may take, as well as smoking or recreational drug use. You’ll provide a brief history of your sex life to rule out any STDs and at that point you provide a semen sample for analysis. Here are the six most common tests to diagnose infertility in men.
- Semen and Sperm Analysis
From your semen sample your doctor can look for any sperm abnormalities as well as any abnormalities that may indicate a condition preventing conception. The sample gets sent to a lab where a trained technician observes your sperm for count, movement and shape. If you have plenty of good swimmers with a normal shape, it’s usually a sign of fertility. But to be on the safe side, your doctor usually orders a second test even if the first is normal.
Sometimes male factor infertility is the result of anti-sperm antibodies in the semen. The antibodies attack the sperm on their way to the egg and prevent fertilization.
If you don’t have a normal sperm count, movement, or shape or if there isn’t much semen you may have a blockage in your reproductive tract. Your doctor orders additional tests to confirm.
- A Physical Exam of Your Scrotum
Your doctor examines your scrotum for varicoceles. These are much like varicose veins. Because of a malformation in the blood vessel, the vein becomes engorged, and coils inhibit sperm production. Your doctor corrects varicoceles through surgery.
There are other blockages and conditions that may be present and your doctor may require additional tests.
With an ultrasound your doctor gets a non-invasive observation of your reproductive system. The ultrasound shows the doctor if there is a blockage and whether your prostate, seminal vesicles and ejaculatory ducts are all normal. The ultrasound also detects ejaculatory disorders such as retrograde ejaculation whereby the semen goes backward into the bladder. This typically results from scar tissue from surgery or undetected infection.
If your ultrasound is inconclusive or your doctor determines an issue with your vas deferens (the main pipeline for sperm) such as a blockage they perform a procedure called vasography. Through a small incision in your scrotum your doctor injects dye (contrast) directly into your vas deferens. This contrast allows the doctor to examine, through a series of x-rays, the condition of your vas deferens.
Some men have a rare genetic condition called congenital bilateral absence of the vas deferens (CBAVD). Doctors associate this condition with cystic fibrosis.
- Testicular Biopsy
If you don’t produce sperm and your hormones are normal and no blockage or varicocele is present your doctor may require a testicular biopsy. The doctor removes a small piece of tissue for examination. This tells how much sperm you produce and if there is an underlying disease or condition.
- Measurement of Your Hormones
The hormonal balance controls sperm – how you make it and how it gets to the egg. Typically, a hormone imbalance is symptomatic of an underlying condition. Low testosterone, the male hormone, causes reduced libido (sex drive), erectile dysfunction and many indicate a pituitary issue or an issue with your hypothalamus, as those are the glands which control testosterone.
The hormone test is a blood test, usually performed first thing in the morning when testosterone is at its peak level. Depending on the results your doctor may repeat the test.
Don’t Lose Heart
Sometimes, for both men and women, the tests don’t reveal an exact cause behind your infertility. If that is the case, don’t lose heart. There are many options available for overcoming infertility. Contact the team at LA IVF today and together we’ll get the answers you need. Together we can journey forward toward your dream of growing your family.