When you seek in vitro fertilization (IVF) or similar fertility treatment, a range of tests must be performed in order to determine the source of your problems. For men, infertility may arise due to a number of different factors, each of which requires a different treatment method. Before visiting our New Orleans clinic, take a moment to understand the various male infertility tests that may be performed.
A Physical Exam
A physical exam is often a good step to diagnosing potential problems, and can be used as a stepping stone for additional testing methods. If a semen evaluation comes back abnormal the patient will be referred. Ideally, a urologist will examine the patient in areas such as testicle size or anogenital distance (AGD). By checking for visible abnormalities and having a frank discussion with patient concerning his medical history, the doctor can begin to theorize possible reasons for infertility and order additional tests.
One of the most common reasons for male infertility, and one that can be initially identified through an exam, is the presence of varicoceles. Varicoceles are an enlargement of the veins responsible for circulating blood from the testicles, thereby regulating their temperature. If these veins are impeded in their function, infertility may arise from abnormally high testicular temperature. If varicoceles are suspected, MRI, X-ray, or ultrasound imaging can be used to more accurately detect them.
A semen analysis is the primary and often most important test of male infertility. By evaluating one or more semen samples, a technician can determine problems in any of the following areas:
- Sperm count: A low sperm count may be the result of numerous factors, but it ultimately accounts for over 90 percent of male infertility cases. If a semen sample contains under 20 million sperm cells per milliliter, the sperm count is considered low.
- Sperm motility: In order for sperm to fertilize an egg, they must be able to move forward in a normal, efficient manner. Motility measures how many sperm have effective forward motion. Generally, 50 percent or more sperm cells should have normal motility.
- Sperm morphology: Morphology refers to how a cell or organism is shaped. Even in healthy, fertile patients, most sperm will actually have abnormally shaped heads or tails, making them unsuitable for fertilization. Ideal numbers for normally shaped sperm range from 15 to 30 percent, but numbers as low as four percent can still indicate a good chance of fertilization, all other factors being positive.
- Semen volume: The amount of semen per sample can indicate if other problems are present. Abnormally low semen volume (below 1.5 milliliters) may indicate blockage, whereas high volume may be a result of inflammation.
Additionally, this test will evaluate factors such as pH level, fructose level, liquefaction time, sperm vitality, and white blood cell count. Although these measurements are not usually as telling as those listed above, together they help indicate any potential problems behind infertility.
A patient’s urine may be analyzed for further insight as to what may be causing infertility. If a semen analysis shows a high white blood cell count, a urinalysis may follow, wherein the sample will be tested for additional white blood cells and antibodies. If the results are abnormally high, it is usually an indication of an infection or inflammation. If sperm cells are present within the urine, it is a likely indication of retrograde ejaculation – a condition in which semen travels backward toward the bladder.
Evaluate Your Fertility
Before undergoing any fertility treatment, it is necessary for both potential partners to have their respective fertility levels tested. Call our office to speak with one of our fertility specialists and schedule your initial consultation and exam.