What are the signs of male infertility, and when should I get tested?
Men with infertility may not realize there’s an issue until they have difficulty conceiving. Proper testing is essential for identifying potential causes and guiding treatment options.
If you’ve been struggling to conceive for at least 12 months, or for at least six months if the female partner is over age 35, it’s a good idea to get tested as soon as possible. It’s also recommended to seek fertility testing if you’re interested in fertility preservation options like sperm freezing, or may be undergoing medical treatments that can impact fertility such as chemotherapy or gender-affirming care. Likewise, if you’ve had a history of testicular issues, surgeries, or known risk factors such as cancer, you should look into getting tested.
Potential Causes of Male Infertility
Male infertility can be caused by various factors, ranging from lifestyle habits and genetics to medical history and hormone imbalances. Some of the most common causes include:
Sperm production and function issues
- Poor sperm motility (movement)
- Abnormal sperm morphology (shape)
- Low sperm count (oligospermia)
- Azoospermia (lack of sperm)
Structural or anatomical issues
- Varicocele (enlargement of the veins within the scrotum)
- Ejaculatory duct issues
- Obstructions or blockages in the reproductive tract
Hormonal factors
- Hormonal imbalances (such as low testosterone)
Genetic factors
- Genetic or chromosomal conditions
Infections and medical conditions
- Infections affecting sperm production or transport
Lifestyle and environmental factors
- Exposure to toxins or high heat
- Smoking, alcohol, or drug use
- Obesity
What is a semen analysis and why does it matter?
A semen analysis is a type of lab test that evaluates sperm health, including sperm count, motility (movement), and shape (morphology), as well as semen volume. Test results can provide valuable insight into overall reproductive health, help identify any issues or conditions that may be causing infertility, and guide treatment options.
A semen analysis is a simple procedure. You’ll be asked to produce a sample in a private location, usually in your home or in a discreet room in your doctor’s office. You may be asked to refrain from ejaculating for a few days beforehand to ensure accurate results.
What other male fertility tests might be recommended?
Aside from a semen analysis, other male fertility tests may also be recommended depending on your medical history and overall fertility goals. These tests may include:
Medical History and Physical Examination
A thorough review of your personal medical history (as well as that of your partner and your family, if applicable) will help doctors identify any conditions or issues that could be impacting your ability to conceive. You’ll also be asked about prior conception history, as well as any injuries, infections, or anatomical concerns. A standard physical exam will likely be conducted as well to identify any potential physical or anatomical factors impacting fertility.
Hormone Testing
Tests may be done to evaluate the levels of certain hormones that can affect sperm production and overall reproductive health. Testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin are often tested, and your doctor will analyze results for any imbalances that may be contributing to infertility.
Genetic Testing
Some men may be recommended genetic testing, especially if they have very low sperm counts or azoospermia (absence of sperm in the ejaculate), or if their partners have experienced multiple IVF failures. These tests can help identify mutations, Y-chromosome microdeletions, and chromosome pairing issues that may impact fertility or cause infertility or other conditions to be passed on to future children.
