Although some people still think of fertility as a "woman's problem," up to half of all cases of infertility involve problems with the male partner. Infertility in a man may be the sole reason that a couple can't conceive, or it may simply add to the difficulties caused by infertility in his partner.

So it's crucial that men get tested for fertility as well as women. It's also important that men do it early. Though some guys may want to put off being tested out of embarrassment, early testing can spare their partners a great deal of unnecessary discomfort and expense. It's also a good way to quickly narrow down potential problems.

Getting Tested

The first thing to do is to go to the doctor, typically a urologist. After a physical examination, your doctor will probably order a semen analysis, which will check the quality and quantity of the sperm in the semen. And yes, your doctor will want you to give the sample there, or at least someplace nearby, since it's important that the analysis take place quickly. Just remember, as sheepish as you might feel, a semen analysis is a commonplace test, and the results could save you months of worry and stress.

If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually means that the man doesn't have any significant infertility problems. If something in the results looks irregular, your doctor might order further tests to pinpoint the problem. At this point, if you aren't already seeing a urologist, you should considering seeing a specialist.

There are a number of potential problems that a semen analysis can detect. They include:

Azoospermia. No sperm are produced, or the sperm aren't appearing in the semen.
Oligiospermia. Few sperm are produced.
Problems with sperm motility. If sperm aren't moving normally, they are less likely to be capable of fertilizing an egg.
Problems with sperm morphology. Problems with the form and structure -- or morphology -- of the sperm may cause infertility.

But while these conditions may be the direct reason that you can't conceive, they themselves may be caused by an underlying medical condition. Your doctor will probably want to investigate the issue further by ordering blood and urine tests or other procedures.

Reasons for Male Infertility

There are a wide number of reasons for male infertility. Some are caused by physical problems that prevent the sperm from being ejaculated normally in semen. Others affect the quality and production of the sperm itself.

Possible problems include:

Sexually transmitted diseases or other infections. Genital infections such as chlamydia and gonorrhea can cause infertility in men. The infertility can often be resolved by treating the infection.
Blockages, birth defects, or physical damage. In some cases, men are born with blockages in parts of the testicle or other abnormalities that prevent sperm from getting into the semen. Physical trauma to the testicles, prostate, and urethra (define) can also result in fertility problems. Surgery can sometimes correct the problem.
Retrograde ejaculation. In this condition, semen doesn't come out of the penis during ejaculation but instead enters the bladder. It can be caused by diabetes, certain medications, and surgery to the bladder, prostate, or urethra.
Genetic diseases. Although it's rare, genetic illnesses such as cystic fibrosis or chromosomal disorders can cause infertility.
Autoimmune problems. In some cases, the immune system can mistakenly target sperm cells and treat them as if they were a foreign virus. The sperm can become damaged as a result.
Hormonal problems. Certain hormonal imbalances -- in the pituitary and thyroid glands, for instance -- can cause infertility. Your doctor may suggest treatment with medication.
Sexual problems. Erectile dysfunction (impotence) and premature ejaculation can obviously have an effect on fertility. Erectile dysfunction can be caused by psychological problems such as anxiety, guilt, or low self-esteem. It is also caused by physical problems such as diabetes, high blood pressure, high cholesterol, and heart disease. In addition, impotence may be a side effect of certain medications such as antidepressants. Talk to your doctor about ways of treating any sexual problems.
Varicoceles. Varicoceles are enlarged varicose veins that develop in the scrotum and prevent blood from flowing properly. Varicoceles are found in 15% of all men, but in up to 40% of men being evaluated for infertility. Although they may be a factor in male infertility, recent studies question whether surgery to correct varicoceles has any beneficial effect.