When a couple struggles to conceive after a year of trying, both partners may need to undergo tests to determine the cause of infertility. For men, evaluating infertility involves several steps, beginning with a medical history review and followed by specific diagnostic tests.
Health Evaluation
The healthcare provider will first ask about any past or current injuries to the genital area. A physical exam will also be performed to check for signs of swelling, discharge from the prostate, or the presence of a hernia or growths. If no visible issues are found, further tests will be recommended.
Semen Analysis
One of the most common tests for male infertility is a semen analysis. The test looks at sperm count, shape, and motility—how well the sperm can swim. If there are any abnormalities, they will be identified. Since sperm count can fluctuate, multiple semen samples may be required for accurate results.
Scrotal Ultrasound
A scrotal ultrasound uses sound waves to create images of the testicles and detect any structural issues. This test can identify varicocele, a condition where veins inside the scrotum become enlarged and cause infertility. Ultrasound can also detect testicular torsion, a condition where the testicle twists within the scrotum, which may require surgical intervention to prevent permanent infertility.
Hormone Level Testing
Spermatogenesis, the production of sperm, is regulated by hormones. An imbalance in hormones like Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) can disrupt sperm production. Blood tests can measure these hormone levels to help diagnose infertility issues.
Testicle Biopsy
In some cases, a testicle biopsy may be performed to examine sperm production. A small sample is taken from the testicle to check for issues like damaged sperm or genetic abnormalities. If sperm production is normal but infertility persists, a blockage or sperm transportation issue may be the cause.
Transrectal Ultrasound
A transrectal ultrasound uses a small probe inserted into the rectum to create real-time images of the prostate and ejaculatory ducts. This test helps to identify blockages in the ducts that could prevent sperm from reaching the egg.
Other Tests
Several additional tests may be used if necessary, including:
- Vital Staining Test: Checks how many sperm are alive in the sample.
- Antisperm Antibodies Test: Detects antibodies that hinder sperm movement.
- Semen Culture: Identifies infections in the semen.
- Hypo-osmotic Swelling Test: Tests the integrity of the sperm’s outer layer.
- Chromosome Analysis: Looks for genetic defects.
- Sperm Function Tests: Assesses how well sperm move, attach to, and penetrate the egg.
Most of these tests are not routinely needed but may be used if the cause of infertility remains unclear. After identifying the issue, healthcare providers can suggest possible treatments to help the couple overcome infertility.
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