identifying the cause of a man's infertility is as much an art as a science. “the first step is an evaluation by a physician specializing in male infertility ” says stephen shaban md a urologist specializing in male reproductive medicine and microsurgery in raleigh north carolina. experts differ in their approach but here are some of the tests you can expect: sperm and semen analysis. they provide a private room (and magazines). you provide a fresh sample of semen. experts then assess your sperm count their shape movement and other variables. “generally a higher number of normal-shaped sperm means higher fertility ” says shaban. but exceptions are common. many men with low sperm counts or abnormal semen are still fertile. and about 15% of infertile men have normal semen and plenty of normal sperm. surprisingly the complete absence of sperm in the semen (a condition known as azoospermia) can be a good thing. lawrence ross md president of the american urological association says it might suggest a blockage in the “plumbing” that can be corrected with surgery. physical examination. a thorough physical exam can detect varicocele and give clues to hormone problems. this should ideally be performed by a urologist. hormone evaluation. testosterone and multiple hormones made in the brain control sperm production. however hormones are not the main problem in 97% of infertile men. testicular biopsy. this is done for men with very low or no sperm in their semen. a needle biopsy of the testicle can show whether a man is making healthy sperm. if abundant good sperm are found in the testicle there's likely a blockage somewhere. genetic testing. genetic tests can identify specific obstacles to fertility and problems with sperm. experts differ as to when genetic tests should be done.
what tests are done to determine the cause of male infertility?