Male fertility is a complex aspect of reproductive health, which in combination with female fertility, affects the overall prospect of parenthood. If you’re preparing for fatherhood and have faced issues when it comes to conceiving a child, a variety of factors come into play. While infertility is a broad term used to describe a variety of issues with sperm and the other aspects of health affecting it, it’s also important to bear in mind that several men with abnormal sperm counts and abnormal semen are still fertile.
Male fertility tests are integral in determining reproductive health and can help you understand what exactly is preventing your partner from getting pregnant. A majority of couples often conceive within a year of trying, so if you’re still within that period, it would be wise to continue. However, if you’ve been trying for well over a year, it might be a good idea to visit a fertility specialist to get the right insights that’ll aid you better when preparing for fatherhood. Read on as we discuss the various aspects of male fertility such as sperm counts, male fertility tests, and what to expect from them.
What Affects Male Fertility?
- While several external and internal factors have an impact on male fertility, certain conditions and substances can have a greater impact on sperm quality and count.
- These factors include:
- Congenital & genetically inherited abnormalities
- Bacterial & viral infections
- Sexually transmitted illnesses
- Neurological ailments
- Trauma & Injury
- Pesticide toxicity
- Heavy metal poisoning
- Sperm antibodies due to autoimmune causes
- Radiation therapy (Specifically in proximity to the gonads)
- Apart from the above-mentioned reasons, male fertility is also impacted by factors such as:
- Alcohol abuse
- Drug abuse
- Male fertility tests aim to understand the various aspects of sperm and to point out what impedes conception in your partner.
How to Test Male Fertility
- Considering the multifactorial nature of male fertility, testing is diverse and looks to include as many parameters as possible.
- If you’re preparing for fatherhood and are considering a fertility test, a general physical examination is usually the first step in approaching male fertility. Your doctor will look for any signs of abnormalities in both your genital area and the rest of your body to assess any impact on fertility.
- Your doctor will follow this up with a detailed medical and family history. Don’t forget to mention any history of surgery or any significant dosage of medications for past illnesses. Also, be honest with your doctor about any fertility issues in the family.
- Sexual history and habits also form a part of the questionnaire, allowing the doctor to understand if there are any aspects apart from sperm count & quality that might be affecting your partner’s conception.
- This might also encompass several questions that cover details of your sexual habits from the point you hit puberty. Spare no detail so that your doctor can have a complete picture of your medical, familial, and sexual history.
- Semen Analysis: Following a detailed physical examination, your physician will recommend you undertake a semen analysis so the medical team can examine your semen and the sperm in it.
- If you’ve been wondering how to check sperm counts, semen analysis is the answer. Semen analysis, in addition to sperm count, measures two other factors - sperm shape and sperm motility (movement).
- Semen analysis is not a single test procedure. Doctors will ask you to undergo at least three analyses when you’re preparing for fatherhood. This is because sperm counts can vary between samples.
- Samples for analyses are taken at least a week apart, however, they’re best conducted over at least 3 months.
- Doctors will often consider the average of these analyses for the final result and arrive at a diagnosis.
- Semen analysis often forms the preliminary test for male fertility. If your doctor thinks there’s something off with your results, they’ll recommend further testing to determine the nature of the problem.
Additional Male Fertility Tests
Following an abnormal semen analysis result, doctors will suggest a variety of tests based on what they think might be the cause of the problem. Some of these tests are mentioned below:
- Post-Ejaculation Urine Testing: A urine test conducted immediately after ejaculation will help your doctors understand if the semen is being ejected backward. Backward ejaculation results in the release of semen into the bladder instead of moving out. This occurs in a condition called retrograde ejaculation, and the presence of sperm in the urine post ejaculation can hint at this problem. This often occurs in case of injuries and surgical complications.
- Ultrasound: The ultrasound examination is a visual test that’s performed using ultrasonic waves to produce images of internal organs and their tissues. In the case of male fertility tests, ultrasound is used in two forms:
- Scrotal ultrasound: Scrotal ultrasounds allow doctors to determine if the testicles and their surrounding structures are normal. They’re primarily used to check for varicoceles in the testicles that are capable of blocking the vas deferens, a tube that carries the sperm to the ejaculatory ducts.
- Transrectal ultrasound: These ultrasounds entail the examination of the prostate and other ducts and structures that carry sperm. The process involves the insertion of a lubricated tube into the rectum to gain better access to the prostate region.
- Hormone Tests: Male fertility tests are incomplete without hormone tests and evaluations. The hormones produced by various glands such as the pituitary gland, testes, and hypothalamus play a major role in the production, maintenance, and nourishment of sperm. Abnormal hormone levels can negatively impact sperm count and quality.
- Biopsy: In some cases, your doctor might think it necessary to collect a few portions of testicular tissue for analysis in the lab. The biopsy often helps doctors understand if the issue is with sperm production. A normal biopsy test would mean the problem lies with either a blockage or sperm motility.
- Liquefaction Test: This test checks the liquefaction rate of semen. Normal semen often liquefies in about half an hour. The liquefaction process allows the sperm to move freely and unimpeded. Upon ejaculation, semen is viscous and thick, however, with time it liquefies, allowing for better movement of sperm. If the semen does not liquefy properly or within the required timeframe, it can negatively affect sperm motility and subsequently, fertility.
- Genetic Analysis: Though the exact period when genetic analysis must be performed in male fertility tests is a debatable topic for medical professionals, doctors often recommend it when they’re unable to arrive at a conclusive diagnosis. Genetic analyses examine your genetic makeup and look for any abnormalities that can affect sperm synthesis or quantity. The Y chromosome can sometimes be smaller than usual - this is an important cause of infertility in some men, and such causes of male infertility can be effectively detected by genetic testing and analysis. Genetic causes for infertility can either be congenital problems or inherited conditions.
- Sperm Antibody Test: In rare situations, the body’s immune system mistakes the sperms to be dangerous and produces antibodies to attack them. This can seriously hamper male fertility and is the prime cause of failure to conceive in a few rare cases.
- The above tests in addition to the preliminary examinations are some of the most common methods of diagnosing fertility issues in men. If you’re preparing for fatherhood and still wondering about how to test for male fertility, speak to your partner and consult your physician for further guidance.
The Properties of Healthy Sperm
- Though fertility can be a complex aspect of reproductive health, healthy sperm on average has a few distinguishable properties that set it apart from abnormal sperm.
- These include:
- Volume: Though this isn’t the most important factor in fertility, the volume does define the amount of sperm available to fertilize an egg. Low volume directly translates to lesser sperm count, and high volume indicates dilute semen. A normal ejaculatory volume is pegged at an amount greater than 2 mL.
- pH: The pH of the semen is an important parameter that determines the survival of sperm. Semen pH is often between 7.2 and 8.0. pH above 8 often indicates an infection, whereas low pH hints at a potential block in the ducts.
- Liquefaction: Normal semen liquefies within 30 minutes. Higher liquefaction time affects the motility and survival of the sperm, compromising fertility.
- Shape: Sperm shape is another important factor in fertility. Semen analysis will determine the semen to be normal if more than 50% of the sperm are shaped normally.
- Count: Sperm count is one of the primary factors determining fertility - however, it isn’t definitive. Irrespective, normal semen analysis sperm count is pegged at between 20 and 200 million sperm per ml for optimal chances of conception.
- Appearance: Semen is whitish to grayish, with an opalescent tint. Any abnormalities such as reddish or yellowish tints can hint at bleeding or jaundice.
- Motility: Like count and appearance, the motility quotient of the semen sample is considered normal if more than 50% of the sperm are capable of moving in a straight line even an hour post ejaculation.
Treatment & Outlook
- Treatments to address issues related to male fertility are often based on the cause.
- If your doctor finds no underlying cause for infertility upon performing an infertility panel, it’s termed idiopathic male infertility, which may involve issues with egg or sperm quality, or even those that may affect the uterus or fallopian tubes, usually necessitating further testing on your partner.
- Other forms of infertility are treated based on the cause.
- Doctors will often recommend surgery in case there’s a blockage in any of your ducts or supporting structures.
- Medical treatments such as those for treating infections and hormone therapy can help when you’re faced with these issues when preparing for fatherhood.
- On the other hand, if your doctor finds no abnormalities in your male fertility test results, they’ll recommend certain lifestyle changes such as increasing the frequency of intercourse and practicing intercourse closer to your partner’s ovulation period.
- Undergoing sex counseling, and other changes such as reducing alcohol intake & quitting smoking are also effective changes you can make when you’re preparing for fatherhood.
- Don’t forget to reach out to your physician in case you’re concerned about your conception journey.