When infertility is a problem, both partners will usually be tested. Often the man is tested first because it is easier to either determine that male infertility is the problem or rule it out. There are several causes that can contribute to male infertility.
When male infertility is suspected, there are a few things the doctor will do to determine the cause. A physical exam will be done to determine if there is a physical problem that may be affecting fertility. Blood may be drawn to determine if there are any hormonal imbalances or infections that may be causing the problem.
A semen analysis will be done to determine the number and quality of the sperm. The sperm sample will be put under a microscope. The sperm will be counted to see if there is an adequate number for conception. The motility, or movement, of the sperm will be tested to determine if the sperm are able to move enough to reach the egg.
The doctor will take a medical history to help in diagnosing the problem. He will ask about past relationships and if conception has ever occurred with any other partner. The doctor will probably ask about past infections. Some infections, such as certain sexually transmitted diseases, can affect male fertility. Some childhood diseases, such as mumps, can cause fertility problems later in life.
A blockage may be the cause of male infertility. This happens when something is blocking sperm from traveling through the vas deferens. This can be due to a past injury, infection, vasectomy or from physical deformity in the scrotum. Sometimes the cause can be successfully treated, once it is determined.
Temperature can cause a failure to produce healthy sperm. Sperm is very sensitive to temperature and a high body temperature can kill them. This can be caused by several factors. Undescended testicles and varicose veins in the testicles can cause a higher than normal temperature and contribute to low sperm count.
Some studies have shown that smoking can contribute to a low sperm count or poor quality sperm. If this is suspected, the man should quit smoking. The good news is that within a year, sperm production usually returns to a normal level. The sooner the cause is detected, the more time you will have to look for treatment options.