Evaluation of Male Infertility

Infertility is a couple’s phenomenon. Our urologists recommend that the female partner be present in order to provide additional information since she is mostly likely being seen by a gynecologist as well. In fact, we recommend that both partners be evaluated: it is not uncommon for both to have some minor abnormalities and to maximize the couple’s reproductive potential.

How is Male Infertility Evaluated?

Infertility is a delicate issue. Georgia Urology Center for Male Infertility understands and provides a compassionate and sensitive environment to evaluate male infertility.

The process begins with:

  1. Complete medical history
  2. Reproductive history of both partners
  3. Physical exam
  4. Semen analysis

From a sample of semen routinely obtained through masturbation into a sterilized cup, our urologist will be able to access factors – volume, count, concentration, movement and structure of spermatozoa – that help or hinder conception.

Even if the semen analysis shows low sperm numbers (oligospermia), or even no sperm (azoospermia), it does not necessarily mean absolute infertility. Low values in any of the above categories may just indicate a problem with the development or delivery of sperm that simply requires further evaluation.

For instance, our urologist may order a trans-rectal ultrasound, an imaging test that places a probe into the rectum to beam high-frequency sound waves to nearby ejaculatory ducts. This test can help our urologist determine if these structures are either poorly developed or obstructed with cysts, calcifications or other blockages.

testicular biopsy comes into play when a semen analysis shows very low number of sperm or no sperm. This test is performed in an operating room under general or regional anesthesia through a small cut in the scrotum. It may also be done in a clinic using a needle inserted through skin over the testicle that has been anesthetized. In either case, a small piece of tissue is removed from each testicle for microscopic evaluation. The biopsy serves two purposes: to determine the cause of infertility, and, if necessary, to retrieve sperm for use in assisted reproduction.

Besides a semen analysis, our urologist may order a hormonal profile to discover the sperm-producing ability of your testicles and to rule out serious conditions. For instance, follicle-stimulating hormone (FSH) is the pituitary hormone responsible for stimulating testicles to produce sperm. High levels may indicate that the pituitary is trying to stimulate the testicles to make are not responding.