If you're a guy and your partner isn't getting pregnant -- even though it's something you both want -- take charge with a visit to your doctor. There are lots of tests you can take to find out if you're infertile -- and learn what kind of treatment you can get.
Get an Evaluation
Start out with a visit to a doctor called a urologist. He'll give you a physical exam and ask you questions about your lifestyle and medical history, such as:
- Surgeries you've had
- Medications you take
- Your exercise habits
- Whether you smoke or take recreational drugs
He may also have a frank discussion with you about your sex life, including any problems you've had or whether you have or ever had any STDs (sexually transmitted diseases). You'll probably be asked to give a sample of semen for analysis.
Finding out the cause of your infertility is as much an art as a science. Male infertility specialists have different ways of doing that, but here are some of the tests you can expect:
Sperm and Semen Analysis
A trained expert checks your sperm count, their shape, movement, and other characteristics. In general, if you have a higher number of normal-shaped sperm, it means you have higher fertility. But there are plenty of exceptions to this. A lot of guys with low sperm counts or abnormal semen are still fertile. And about 15% of infertile men have normal semen and plenty of normal sperm.
If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually mean you don't have any significant infertility problems. If something in the results looks unusual, your doctor might order more tests to pinpoint the problem.
If you don't have any semen or sperm at all, it might be because of a blockage in your "plumbing" that can be corrected with surgery.
It can find varicoceles -- abnormal formations of veins above the testicle. You can get it corrected with surgery.
Testosterone and other hormones control the making of sperm. Keep in mind, though, that hormones aren't the main problem in 97% of infertile men. Experts disagree as to how big a search should be done for hormonal causes of infertility.
It can identify specific obstacles to fertility and problems with your sperm. Experts differ on when genetic tests should be done.
Some men make abnormal antibodies that attack the sperm on the way to the egg, which keeps your partner from getting pregnant.
For other guys, making sperm isn't the problem: It's getting the sperm where they need to go. Men with these conditions have normal sperm in their testicles, but the sperm in semen are either missing, in low numbers, or abnormal.
There are several reasons you might have low sperm in your semen even if your body makes enough of it:
Retrograde ejaculation. In this condition, your sperm ejaculates backward, into your bladder. It's usually caused by an earlier surgery.
You're missing the main sperm pipeline (the vas deferens). It's a genetic problem. Some men are born without a main pipeline for sperm.
Obstruction. There can be a blockage anywhere between the testicles and the penis.
Anti-sperm antibodies. As mentioned, they attack your sperm on the way to the egg.
"Idiopathic" infertility. It's a fancy way of saying there isn't any cause your doctor can identify for your abnormal or low sperm count.
Don't hesitate to get tests to check your fertility. When you and your partner do this, it will help you figure out what's going on, and let you learn about treatment.