Male Fertility Diagnosis 2017-04-24T11:38:25+00:00

Male Fertility Diagnosis

Sperm Count & Infertility

The basic sperm count, achieved by masturbation and examination of the sperm 2-5 days after abstinence, is one of the mainstays of making an infertility diagnosis and should be done even when there is a female factor identified. As many as 40% of couples with fertility problems have conditions affecting both partners.

Sperm Function Testing

The ability of a sperm to penetrate a human egg is an important issue. Low sperm counts and low motility on the Semen Analysis can often predict whether the sperm that are present are sufficient in numbers and activity to reach and combine with the eggs. Other than mixing eggs and sperm in a dish at the time of in-vitro fertilization, there is no definitive way to prove that sperm are functioning properly. In rare cases, some men with completely normal Semen Analysis numbers may be found to have sperm that cannot bind to human eggs. Unfortunately, this is usually discovered during IVF.

Sperm DNA Integrity

There has been a lot of recent interest in evaluating patients with unexplained infertility, repeated reproductive failure, and recurrent miscarriage by evaluating the male’s sperm for DNA fragmentation. These tests are not 100% predictive but may indicate in these rarer cases whether or not the sperm, rather than the egg, is leading to infertility.

Age-related Infertility

Some studies have suggested that advanced male age (usually over age 50) may lead to increased infertility and increased rates of miscarriage. The data in the literature on this is mixed: some studies showing paternal age to have an effect and some not finding it to be very predictive. If there is an effect of paternal age, it may be a small effect.

Genetic Causes of Male Infertility

Men with Klinefelter’s syndrome (47 XXY chromosome makeup instead of 46 XY), men with deletions of parts of the Y chromosome, men with balanced translocations, and a few other rarer genetic abnormalities will be affected by male infertility.

Sexual Dysfunction

Although this might primarily have to do with one or the other partners in a couple (e.g. erectile dysfunction in men), oftentimes, sexual dysfunction is a couple’s challenge and must be addressed by assessing both partners.

Unexplained Infertility in Men

This is the diagnosis given when all the other tests are normal. Many couples failing to conceive after 1-2 years of trying, with all the usual tests coming up normal, may actually have age-related sub-fertility or endometriosis. On the other hand, there may be other diagnoses or medical problems that we have just not come to understand yet.