Male infertility
About 15% of couples have difficulty conceiving, and a male factor is involved in nearly half of them. Men should be evaluated at the same time as their partner.
Medically reviewed by Dr. Chirag Dave
Evaluation
- Semen analysis: volume, sperm count, motility, shape and other factors, repeated at least once because results vary. Avoid ejaculation for 48 to 72 hours beforehand.
- Hormone testing: FSH, LH, testosterone, prolactin and estradiol.
- Specialized semen tests: white blood cells, antisperm antibodies, reactive oxygen species, strict morphology and DNA damage.
- Genetic testing when indicated.
Treatment
Depending on the cause, treatment can include medication, surgery such as varicocele repair or vasectomy reversal, and sperm retrieval procedures such as MESA and micro-TESE.
Common causes
- Varicocele: enlarged veins in the scrotum, a common treatable cause.
- Hormone problems: including low testosterone or problems with the pituitary gland.
- Blockage: of the tubes that carry sperm, including after a vasectomy.
- Genetic conditions that affect sperm production.
- Medications and lifestyle: testosterone therapy, some other medicines, smoking, heavy alcohol or drug use and heat exposure can lower sperm production.
Testosterone and fertility
Testosterone therapy can lower sperm production. If you are trying to conceive or may want children, tell your doctor before starting treatment for low testosterone so you can discuss options.
Your first visit
Bring any previous semen analysis and lab results. The visit includes a health and reproductive history, a physical exam and a plan for testing. Couples are encouraged to coordinate the man's evaluation with the partner's fertility care.
Resources
Talk with a urologist
Appointments at 14 Advanced Urology offices across metro Atlanta and north Georgia. Find an office.