I’m a recently married 32-year-old man. My wife and I haven’t used birth control for the last few years and are beginning to wonder if there might be something wrong. She wants us to both get checked out by a fertility specialist. Frankly, I’m a bit nervous about the idea. What does male fertility testing involve and how will I know if I am fertile?

Written by our medical expert Dr. Stephen Hudson, Director of the Victoria Fertility Centre in British Columbia, Canada.  

When couples have trouble conceiving, there is always anxiety about where the problem may lie. The “could it be me?” question is always a worry, but please remember that building a family is a team event. You and your partner do this together.

The truth is, that in many cases there may be subtle factors in both the man and the woman – which together may be affecting their success in getting pregnant. It’s normal to be nervous, because the idea of needing help with such an intimate and personal venture, is enough to stress most people out. There are so many emotions when considering the prospect of infertility investigations and treatment – that the whole process can feel overwhelming.

So – although it is normal to be nervous when facing medical fertility investigations and possible treatment, it should also be exciting to start the journey towards identifying and dealing with whatever is preventing you from getting pregnant. Because – the truth be told, we fertility specialists can often help, whatever the problem may be.

At the first medical consultation we normally see couples together and start with a comprehensive history – to gather some basic information regarding both of you. You have specifically asked about male fertility testing – so although I will focus on answering your question, as fertility specialists, we do approach you and your partner together.

Some of the questions we may ask you are related to your medical history…specifically developmental problems (such as being born with an undescended testicals), infections, surgeries, sexual functioning, specific discomfort or pain, frequency of intercourse, etc). We may also ask about your family history because this too could be relevant in terms of your current fertility.

If there are any issues which raise suspicion, then specific tests would be requested. However, the most basic of tests that is always recommended for the male partner is a semen analysis. This is offered in local laboratories in most cities and towns, and in the on-site labs of most fertility clinics. Usually these tests are carried out by appointment. In preparation for a semen analysis, you would be asked to abstain from ejaculating for 3 days – then to produce a semen sample by masturbation (being careful not to use a spermicidal lubricant!). The laboratory staff will then undertake some testing which includes, assessing the volume of semen, the sperm count, the motility (how well the sperm swim around) and the morphology (a detailed examination under the microscope of the shape and condition of a few hundred sperm).

This basic semen analysis will provide enough information to move forward. However, you do need to be aware that this analysis is only a guide and a starting point. Also, given that semen analyses can vary significantly, if the first test is abnormal, we always repeat the test before making assumptions or a definitive diagnosis.

In addition to a physical examination, some additional tests may be requested, which might include a repeat semen analysis, blood tests and an ultrasound of the testicles. Based on the outcome of the physical examination and on the findings of your tests and those of your partner, your fertility specialist will then use this information to guide you and your partner in your efforts to become parents. I hope this helps!


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