What Tests Are Done for Male Infertility?

If you and your partner have been trying to conceive, you've likely come to a point where you're wondering, "What Tests Are Done for Male Infertility?". It's a question many men face, and it's a critical one because male factor infertility accounts for nearly 50% of all infertility cases. The good news is that a comprehensive evaluation is usually straightforward, non-invasive, and can provide the answers needed to create a successful path forward.

 

Let's walk through the standard diagnostic process, from the initial consultation to more advanced tests, to give you a clear understanding of what to expect on this journey.

 

The Initial Evaluation: Getting Started

 

The first step in any male fertility assessment is a thorough medical and physical examination. This is your chance to discuss your health history with a specialist, such as a urologist or a reproductive endocrinologist at a Fertility Clinic in Kenya.

 

During this initial visit, the doctor will ask questions about:

 

(i) Medical History: Past surgeries, chronic health issues, childhood illnesses (like mumps), and any medications you are taking.
 

(ii) Sexual History: Your sexual habits and any difficulties you may be experiencing, such as erectile dysfunction or ejaculation issues.
 

(iii) Lifestyle Factors: Your diet, exercise habits, use of alcohol or tobacco, and exposure to environmental toxins or heat.

 

A physical examination will then be performed to check for any visible abnormalities, such as varicoceles (enlarged veins in the scrotum), which are a common and reversible cause of male infertility.

 

Semen Analysis: The Cornerstone of Testing

 

A semen analysis is the single most important test for male infertility. It provides a detailed look at the health of your sperm and is the first lab test you will be asked to do. The sample is typically collected at the Fertility Clinic via masturbation and must be analyzed within a short window (usually 30-60 minutes) to ensure accuracy.

 

The lab will evaluate several key parameters:

 

(i) Volume: The amount of semen produced. An abnormally low volume can indicate a blockage.
 

(ii) Sperm Concentration (Count): The number of sperm per milliliter of semen. A low count is known as oligospermia.
 

(iii) Motility: The percentage of sperm that are moving. This is a measure of how well sperm can swim. Low motility is called asthenozoospermia.
 

(iv) Morphology: The size and shape of the sperm. Sperm with abnormal shapes may have trouble fertilizing an egg. The Kruger or "strict criteria" for morphology is one of the most common methods used.
 

(v) Liquefaction: Semen is initially a gel and should turn to a liquid within about 20 minutes. If it doesn't, it can hinder sperm movement.

 

Since sperm quality can fluctuate, your doctor may recommend two or more semen analyses a few weeks apart to get a reliable average.

 

Advantages of Semen Analysis:

 

(i) Non-invasive: The test itself is simple and causes no physical discomfort.
 

(ii) Comprehensive: It provides a wealth of information about sperm health.
 

(iii) Foundational: The results guide the need for any further testing or immediate treatment.

 

Disadvantages of Semen Analysis:

 

(i) Variability: Results can change due to recent illness, stress, or time since the last ejaculation.
 

(ii) Not a Complete Picture: A normal semen analysis doesn't guarantee fertility, as other factors may be at play.

 

Advanced Diagnostic Tests

 

If the semen analysis results are abnormal, your specialist will likely recommend further testing to pinpoint the underlying cause. These tests delve deeper into hormonal, genetic, and structural issues.

 

1. Hormone Testing: Hormones play a crucial role in sperm production. A simple blood test can measure the levels of key hormones, including:

 

(i) Follicle-Stimulating Hormone (FSH): Produced by the pituitary gland, this hormone stimulates sperm production in the testes. High levels may indicate a problem with the testes.
 

(ii) Testosterone: The primary male sex hormone, essential for sperm production and overall male reproductive health.
 

(iii) Luteinizing Hormone (LH): Also from the pituitary gland, it tells the testes to produce testosterone.

 

2. Genetic Testing: Genetic issues can be a cause of very low or absent sperm count. Genetic tests may be done to check for:

 

(i) Y-Chromosome Microdeletions: Tiny missing pieces of the Y chromosome, which are essential for sperm production.
 

(ii) Karyotyping: A test to look at the number and structure of chromosomes. Klinefelter syndrome, for example, is a chromosomal condition that can cause male infertility.
 

(iii) Cystic Fibrosis Gene Mutation: A mutation in this gene can cause the absence of the vas deferens, the tube that carries sperm, leading to a lack of sperm in the ejaculate.

 

3. Ultrasound and Imaging: Ultrasound is a non-invasive tool to look for physical blockages or abnormalities.

(i) Scrotal Ultrasound: This test uses sound waves to check for varicoceles and other issues in the testicles and epididymis.
 

(ii) Transrectal Ultrasound: This may be used to look for blockages in the ejaculatory ducts or issues with the seminal vesicles or prostate.

 

4. Post-Ejaculation Urinalysis: This test checks for the presence of sperm in your urine. If sperm is found, it may indicate retrograde ejaculation, a condition where semen travels backward into the bladder instead of out of the penis.

 

Surgical Diagnostics and Treatment

 

In cases where there is no sperm in the ejaculate (azoospermia), but the testicles are producing sperm, a surgical procedure may be needed to retrieve sperm directly. These procedures are often both diagnostic and therapeutic, meaning they help find the cause while also providing sperm for an IVF cycle.

 

(i) Testicular Sperm Aspiration (TESA): A fine needle is used to aspirate sperm directly from the testicle.
 

(ii) Testicular Sperm Extraction (TESE): A small incision is made in the testicle to remove a small sample of tissue from which sperm can be extracted.

 

Advantages of Surgical Retrieval

 

(i) Bypasses Blockages: Allows sperm to be retrieved even if there are blockages in the reproductive tract.
 

(ii) Provides Sperm for IVF: The retrieved sperm can be used for Intracytoplasmic Sperm Injection (ICSI), a form of IVF where a single sperm is injected into an egg.

 

Disadvantages of Surgical Retrieval

 

(i) Invasive: It is a surgical procedure with associated risks and recovery time.
 

(ii) Not a Guarantee: There is a chance that viable sperm will not be found.

 

Male Infertility Treatment in Kenya

 

Once the tests are complete and a diagnosis is made, your doctor at a Fertility Clinic in Kenya will discuss a personalized treatment plan with you. The approach to Male Infertility Treatment in Kenya is modern and comprehensive, reflecting a deep understanding of the causes.

 

(i) Lifestyle Changes: For some, simple changes like a healthier diet, exercise, quitting smoking, and reducing alcohol can significantly improve sperm health.
 

(ii) Medications: Hormone imbalances can often be corrected with medication.
 

(iii) Surgical Correction: Conditions like varicocele or blockages can be corrected with surgery, often restoring natural fertility.
 

(iv) Assisted Reproductive Technology (ART): For many, particularly with severe male factor issues, ART is the most successful option. IVF with ICSI is a revolutionary technology that can lead to pregnancy even with very low sperm counts or poor motility.

 

Fertility Point is a great example of a clinic that offers these advanced services. They have a dedicated team of specialists who understand the complexities of male infertility and are equipped with the latest technology to provide effective treatments. They are committed to providing you with the answers you need and the best possible care on your path to fatherhood.

 

Summary

 

The process of determining what tests are done for male infertility is a structured and scientific one. It begins with a basic semen analysis, followed by more advanced hormonal, genetic, and imaging tests if needed. The goal is to identify the root cause of infertility and create a targeted treatment plan. From lifestyle adjustments to surgical procedures and cutting-edge treatments like IVF with ICSI, a wide range of effective solutions is available. In Kenya, specialized clinics like Fertility Point are at the forefront of providing comprehensive diagnostic and treatment services, ensuring that men have the support they need on their fertility journey.