Diagnosing Male-Factor Infertility

Men are known to struggle with infertility at equal rates as women. Therefore, a detailed examination of both parties is necessary for couples trying to get pregnant. For men, a semen analysis is often the first step in diagnosing male-factor infertility. Understanding the results of a semen analysis can provide valuable insights into why conception has not yet occurred. Generally, the results of a semen analysis will reveal at least 1 of the following 4 reasons for male-factor infertility.

1. Not enough sperm

Oligospermia, or low sperm count, is a common condition that can significantly impact male fertility. Low sperm count is defined as having less than 15 million sperm per 1mL of ejaculate. Azoospermia is the absence of any sperm in the sample. Poor sperm count can arise due to various factors, including genetic abnormalities, hormones, medical conditions, lifestyle choices, and environmental factors. Sperm quantity plays a crucial role in achieving successful fertilization. When the sperm count is below the normal range, the chances of healthy sperm reaching and fertilizing an egg are reduced.

2. Can your sperm move?

Poor sperm motility, or asthenospermia, is a condition that affects the movement and swimming ability of the sperm. Sperm motility plays a crucial role in fertility. Effective movement allows the sperm to navigate the female reproductive tract and reach the egg for fertilization. When sperm have poor motility or move in an abnormal pattern, the chances of pregnancy are reduced. A diagnosis of low motility is made when at least 40% of the sperm in the sample are affected.

3. Abnormal morphology

Teratospermia, or abnormal sperm morphology, is when many sperm have irregular shapes and structures. Sperm morphology is an essential aspect of male fertility. The shape of the sperm directly impacts the ability to fertilize an egg successfully. In a standard semen analysis, sperm are evaluated for morphology, among other parameters. These parameters assess sperm health and fertility potential. Sperm with abnormal morphology may have irregular head shapes, tail abnormalities, or other structural defects. These abnormalities can hinder the sperm's ability to swim efficiently, navigate the female reproductive tract, and ultimately penetrate the egg for fertilization.

4. Ejaculatory disorders

For some men, the sperm is healthy, but the ability to ejaculate prohibits pregnancy. Ejaculatory disorders have various underlying causes and can significantly impact a man's fertility. When ejaculation is impaired, sperm cannot reach the woman's reproductive tract, hindering the chances of conception. There are different types of ejaculatory disorders, including premature ejaculation, delayed ejaculation, retrograde ejaculation, and anejaculation. These conditions either prevent, reduce, or delay the release of seminal fluid during intercourse. With a semen analysis, this concern can be detected by looking at the total ejaculate volume or if a man reports an inability to produce a sample.

Taking control with treatment

Problems with sperm production, function, and transport can all lead to fertility challenges. Understanding the common causes of male-factor infertility provides a starting point for diagnosis and treatment. Depending on the exact results, the medical team can provide medication or suggest lifestyle changes to improve sperm quantity and quality. Should these fail, assisted reproductive technology (ART) treatments, such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), can be used to improve the chances of a successful pregnancy and healthy baby.