When a couple has fertility problems, it’s usually the woman who wants to get advice early on, but there’s no point in her doing this on her own. If a couple is having difficulty in conceiving, it really doesn’t make sense for the man to delay testing. A semen analysis should always be the first test to be done if fertility is to be investigated.
How Men Can be Helped
Studies suggest that sperm counts decreased during the 20th century because of environmental factors such as exposure to estrogens in foodstuffs and chemicals used in the plastics industry that enter the food chain. At one time, much more was known about female infertility than male, but fertility clinics now deal just as much with male problems and diseases. There’s a greater chance than ever before that men who have low fertility or are infertile can be helped to achieve natural fatherhood.
Male infertility has nothing to do with virility. A man’s sperm may be incapable of fertilizing an egg, yet he may be an excellent lover. In contrast, a man who is unable to make love to a woman may have perfectly viable, fertile sperm.
Semen Analysis
One of the first tests for a man is semen analysis. Two samples are usually analyzed, since sperm counts can vary according to circumstances, such as how often he has sexual intercourse. The analysis checks the number of sperm in a sample, how well and how much they move, and their shape. Many specialists believe that even a relatively low sperm count may not affect a man’s fertility. But if he has a low sperm count combined with many sperm that are malformed, move poorly, or both, or if there is a high white blood cell content, then it’s likely that his fertility will be affected.
Low sperm counts - There are several types of low sperm counts. A semen analysis decides which of the following definitions apply to a particular sperm sample.
- Azoospermia: there’s no sperm in the semen, either because the man cannot make sperm, he has a blockage affecting the sperm transportation, or he fails to ejaculate
- Oligospermia: there are fewer than 20 million sperm per ml of semen. A mild case is fewer than 10-20 million, a moderate case is 5-10 million, and a severe case would be fewer than 5 million
- Aesthenospermia: sperm are unable to wriggle even if the count is normal
- Teratospermia: a high number of abnormal sperm. This is severe if the man has more than 70 percent abnormal sperm, possibly caused by a chromosomal abnormality or by some kind of environmental damage.
Secondary Test For Sperm Function
After routine semen analysis, microscopic tests of sperm function would be done only at a specialist clinic as part of the secondary stage of investigation of a couple with infertility problems. Special tests examine
- the ability of sperm to penetrate mucus so they can get through the cervix to the uterus, and from there to the tubes and egg
- the ability of the sperm to recognize the egg and latch on to itÂ
the first step in fertilization (the acrosome test) - the ability to fuse with and fertilize the egg (the egg penetration or hamster test).
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