 [ Symptoms ] hello i am an african anerican male who had an unprotected sexual encounter about five months ago odds of hiv  hello i am an african anerican male who had an unprotected sexual encounter about five months ago she cut my penis with her teeth then we had unprotected sex for about 1 minute sometime later we discovered she was bleeding i have started experiencing these symptoms after a caffiene detox also i have experienced an itchy anus i also have a cut above that pesky and just will not heal i work out pretty hard i have cut my caffiene intake by 15 the symptoms i have are diarrhea as well as fatigue [ Disease ] identifying the cause of a man is 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 is 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