It is now obvious that no matter what your female fertility testing indicates, most men must also be evaluated for their own fertility. Male fertility testing is typically much simpler and straightforward than the woman’s. The reason being that
- The male reproductive organs are located outside of the body.
- The male hormones are usually steadier and not subject to the monthly cyclic changes as seen in women
In the first visit to the doctor, he/she will take a detailed medical, drug, social and fertility history.
After the history ad physical examination, the doctor will perform some tests to help in diagnosis of infertility and try to find the exact cause. The following are descriptions of a variety of tests and procedures that you may encounter during your fertility evaluation.
Blood tests
The tests done in blood are helpful in finding out the normal factors such as:
- Hormone testosterone tests. Testosterone is a primary male hormone, directly linked to sex drive and function. It is also associated with sperm growth and maturation
- Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which both play a key role in sperm production
- Prolactin hormone test may indicate presence of a pituitary brain tumor or could be a sign of an abnormal thyroid function
- Human immunodeficiency virus (HIV) test
- Hepatitis test
- Syphilis (VDRL) test.
Semen analysis tests
The semen will be checked for the presence of white blood cells. If a large number of white blood cells are present, this may indicate an infection. Other tests done on semen include tests for specific bacteria and viruses. The following are the key infections typically checked during a basic fertility evaluation of semen:
Urine tests
A urinalysis is performed to help diagnose
- The presence of bacteria and the white blood cells. White blood cells may indicate an infection either within the urinary tract or the prostate gland.
- The urine is also checked for the presence of sperm. A high concentration of sperm in the urine may indicate retrograde ejaculation where sperm go backward into the bladder instead of moving forward into the penis.
The semen analysis test
During ejaculation, semen is produced from a concentrated suspension of spermatozoa, stored in the paired epididymides, mixed with, and diluted by, fluid secretions from the accessory sex organs. The semen is emitted in several boluses. About 90% of semen volume is made up of secretions from the accessory organs mainly the prostate and seminal vesicles, with minor contributions from the bulbourethral (Cowper’s) glands and epididymides.
Semen analysis test is a major part of the male fertility assessment. This test checks for both the quality and quantity of sperm. The semen sample is obtained by the male partner through
- Performing masturbation either at home or in other situations, the semen sample must be obtained at the clinic or laboratory.
- Using the non-spermicidal condoms used during intercourse at home
How to prepare for semen collection
Preparation
- The healthcare provider will provide a private room near the laboratory, where you will collect the semen and hand over to the lab staff. The specimen container should be kept at ambient temperature, between 20 °C and 37 °C, to avoid large changes in temperature that may affect the spermatozoa after they are ejaculated into it. This helps to minimize the exposure of the semen to fluctuations in temperature and to control the time between collection and analysis
- The man is advised to abstain from sexual intercourse for minimum of two days and a maximum of seven days. The doctor must give you clear written and spoken instructions concerning the collection of the semen sample. You are advise to report any loss of any fraction of the sample as this is also measured
Semen collection
Collecting semen at the laboratory;
The man should:
- Pass urine all urine
- Wash the hands and penis with soap, to reduce the risk of contamination of the specimen with bacteria or viruses from the skin.
- Rinse the soap away from the hands and the penis with water.
- Dry hands and penis with a fresh disposable soft towel.
- Perform the masturbation and ejaculate into a sterile container.
Collecting semen at home
This is only done in exceptional circumstances, such as a demonstrated inability to produce a sample by masturbation at the laboratory or the lack of adequate facilities near the laboratory. The same instructions are followed.
- The lab technologist will provide a pre-weighed container, labelled with the patient’s name and identification number.
- The same cleaning procedure is advised and semen collection time and delivery time recorded.
- During transport to the laboratory, the sample should be kept between 20 °C and 37 °C if possible
Collecting semen by condom
The same reason applies for this means as in the collection using a container at home
- The man is provided with special non-toxic condoms designed for semen collection. Such are available commercially.
- Information on how to use a condom is usually provided
- The time of collection and delivery to the lab must be recorded. The same should be stored at a temperature between 20 °C and 37 °C.
- It should e noted that coitus interruptus is not a reliable means of semen collection, because the first portion of the ejaculate, which contains the highest number of spermatozoa, may be lost.
Testing the semen specimen
Once the semen sample is obtained, it is analyzed in the laboratory. The semen sample is typically evaluated under a microscope and/or by computerized evaluation.
The key features studied are:
- Semen volume per ejaculation
- The thickness (viscosity) of the semen
- The quantity (concentration) in terms of the number of sperm present in the semen
- The shape (morphology) of the sperm in percentage of normally shaped sperm against the abnormal ones
- The sperm movement (motility). This can be forward, circular or irregular movements.
Continue reading Testing for Fertility in Men part two.
