Testing for Male Infertility

July 16, 2020 | By Jessica Moncivais

If you and your partner have not gotten pregnant after a year of unprotected sex, you might want to consider having your partners sperm health evaluated. Understanding the factors that can affect male fertility can help you both achieve your pregnancy goals.

A semen analysis measures three major factors of sperm health:

1. The number of sperm - a healthy sperm count is about 15 million or more for every milliliter (mL) of semen (the discharge in a single ejaculation). You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate. Too little sperm in an ejaculation might make it more difficult to get a woman pregnant because there are fewer sperm available to fertilize the egg.
2. The shape of the sperm - a normal sperm has a smooth, oval-shape head (5-6 micrometers long and 2.5-3.5 micrometers wide) with a long tail. The head shape is important because it affects the sperm’s ability to dissolve through the outer surface of an egg and fertilize it. The more normal shaped sperm you have, the more likely you are to be fertile.
3. Sperm motility - progressive motility refers to sperm that swim in a straight line or in very large circles. Non-progressive motility refers to sperm that move but do not swim in progression or swim in very tight circles. Progressive motility is needed for the sperm to swim their way up the female reproductive tract. You are most likely to be fertile if at least 40% of your sperm are moving progressively.

If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually mean you do not have any significant infertility problems. If something in the results looks unusual, your doctor might order more tests to identify the problem.

Causes of Infertility

Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility:

Medical Conditions 

Varicoceles. One of the most common causes of male infertility. This is swelling of the veins that drain the testicle.

Infections. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. 

Antibodies That Attack Sperm

Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.

Hormone Imbalances

Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone and other hormonal problems have several possible underlying causes.

Environmental Issues

Being exposed to industrial chemicals, heavy metal exposure, overheating the testicles or radiation on the job, or in and around the home can reduce sperm production. In some cases, it can permanently reduce production.

What You Can Do

If you are trying to conceive, try limiting alcohol consumption. Maintain a healthy weight and diet. Exercise and sleep are so important during this time. Eating more anti-oxidant rich foods or introducing healthier fats into your diet can even help increase sperm count. Emotional health is always an important part of overall health. Be sure you are taking the necessary steps to manage or reduce your emotional stress. As stated in a previous blog, stress may impact aspects of fertility for both you and your partner.

Many types of male infertility are not preventable. However, you can avoid some known causes of male infertility just by making better choices.

Sources:

https://www.healthline.com/health/mens-health/normal-sperm-count

https://www.ucsfhealth.org/medical-tests/003627

Updated August 24, 2020