Medical help should be sought if you’ve been trying for a year and haven’t been able to conceive on your own. The waiting period is less if your partner is over 30 or if you know of a preexisting medical condition.
Unlike female infertility, the cause of which is often easily identified, diagnosing male factors can be more difficult. The problems, however, usually fall into two areas — sperm production and/or delivery.
Because male infertility results from such varied factors, you will need to see your physician to sort out the possibilities. A primary care doctor can often locate the problem by completing an initial evaluation. Further evaluation by an urologist or reproductive specialist may be necessary if you and your partner have been trying unsuccessfully for a year to get pregnant or if you have a known male, such as an undescended testicle.
In any case, the evaluation usually includes medical and surgical histories. The doctor will want to know about childhood diseases (e.g., mumps), current health problems (e.g., diabetes), or even medications (e.g., anabolic steroids) that might interfere with the formation of sperm. Your physician will also ask about your use of alcohol, marijuana and other recreational drugs, as well as your exposure to such the occupational hazards of ionizing radiation, heavy metals and pesticides. All affect fertility.
Every evaluation will also include an assessment of your sexual performance, along with you and your partner's joint efforts to achieve pregnancy. For instance, your doctor will investigate whether you’ve had difficulty with erections and if your ejaculate has sufficient quality and volume. Such factors can adversely affect your sperm's effectiveness for pregnancy.
In addition to conducting a general exam, your doctor will look for any penile abnormalities.
Semen analysis is a routine test that is the single most important lab indicator for male infertility. Completed twice, it helps urologists define each factor and its severity. In addition to the above screens, other tools to assess fertility, including transurethral ultrasonography, which detects ejaculatory duct obstructions, and testicular biopsies which substantiate any reproductive, may be used.
Getting a complete evaluation should help you and your partner understand your infertility issues and make better decisions about treatment.
Your treatment options will depend entirely on the factors causing your infertility. The good news is that few medical fields have progressed as dramatically during the past decades as reproductive medicine, particularly as it pertains to men.
Today, many conditions can be corrected with drugs or surgery thus enabling conception to occur through normal intercourse.