Work Up for Male Infertility

What is Male Infertility?

Male infertility is a condition where due to some underlying health condition, a man is not able to make her wife pregnant. These underlying conditions are infertility problems that reduce the chances of normal pregnancy. There are various causes behind male infertility like low sperm count, no sperm count, poor sperm production, some environmental factors, etc. The exact infertility problem in a male is diagnosed with a procedure called workup of male infertility.

These tests include some information on medical history, physical examination, and tests. These tests then rule out if there is an infertility problem in a male.

Everything You Need to Know About Male Infertility Workup

Workup for Male Infertility | Steps

Workup for male infertility

Male infertility is also one of the major reasons where a couple is facing difficulties in having a child. Male factor infertility is a cause of infertility in 40% of couples. Workup of male infertility includes an evaluation of the male partner to know the exact issue that is causing problems.

Workup of male infertility is like that of a female that includes some tests and investigations that rule out the exact fertility issue in a male partner. This evaluation is minimal and includes only the detailed reproductive history and semen analysis.

Steps of Infertility workup for a male

We evaluate the total evaluation of male infertility by three major steps, which are:

Medical History

The key factors in the medical history will include information on reproductive history, medications, surgical and medical history as well. This also includes the details of lifestyle, family history, or information about any past illnesses or infections. Your doctor will look out for certain things like:

• Frequency and timing of coitus or intercourse.
• Any signs of sexual dysfunction, including ejaculation or erectile issues.
• Duration of infertility
• Prior fertility
• Any childhood illness and its developmental history
• Any systemic medical illness.
• Some previous surgery (eg, cryptorchidism with or without surgery)
• Any medication consumption including anabolic steroids and supplements (eg, testosterone), or for allergies.
• Sexual history, along with sexually transmitted infections.
• Exposure to gonadal trauma or toxins.

Semen Analysis

Semen analysis is the essential step of a man’s infertility evaluation. It tells us about the severity of the male infertility factor. Semen analysis is the quantitative evaluation of sperm parameters done under a high magnification microscope. Two to five days of abstinence is optimal before doing semen analysis. This way it ensures the best results.

Ideally, the semen sample is obtained by masturbation in the laboratory collection room. But on the other hand, semen collection at home is also possible if we transport the sample to body temperature for evaluation within 30 minutes. If there are abnormalities on semen analysis, repeat testing and further investigation should be done.

Semen analysis tells us a lot about the semen volume, sperm concentration in it, sperms’ motility and morphology. Once the semen analysis is done, your doctor can conclude after seeing the reports.

Specialized Test For evaluation Of Male Infertility

There are certain specialized tests that may be offered in specific cases of recurrent miscarriages or repeated IVF failures or severe oligospermia depending on clinicians discretion:

• DNA fragmentation Index
• Karyotyping
• Y chromosome microdeletion testing
• Cystic Fibrosis Gene Testing

Unexplained Infertility

Unexplained infertility may be diagnosed in as many as 20 to 30% of infertile couples. Unexplained infertility occurs when the definition of infertility is met, the basic infertility evaluation is performed, and all the test results are normal. At a minimum, these patients should have evidence of ovulation, tubal potency, and a normal semen analysis.