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Causes and Tests of Male Fertility

A man’s fertility can be affected by factors such as a low sperm count, poor sperm movement (motility), clumped (or agglutinated) sperm (unable to swim to the egg), abnormally shaped sperm, enlarged veins around the testes (varicoceles), obstructions that prevent sperm from being released during ejaculation, and genetic or congenital conditions that impair the reproductive environment. The most common anatomic abnormality in men is varicoceles.

A history of having mumps, testicular injury, exposure to chemicals or toxins, acute illness or prolonged fever, drug or alcohol use, and ingestion of anabolic steroids can negatively impact male fertility. Temperature also affects sperm efficiency. Age-related problems include decreased testosterone production; declining sperm mobility or production; prostate, erectile, or ejaculation problems; and excessive alcohol use.

For the male, a medical history and physical examination to detect anatomic abnormalities may be all that is necessary to diagnose an infertility problem.

Semen analysis
Semen analysis is the mainstay of male testing. Collection and prompt evaluation of an ejaculate can quickly determine any abnormalities in the number of sperm, their shape, and ability to swim toward the egg.

Blood tests
Measurements of the levels of some hormones in blood may contribute to understanding in male reproductive disorders: testosterone, luteinising hormone (LH), follicle-stimulating hormone (FSH), and prolactin (PRL).

In some instances a biopsy of testicular tissue may be required to identify the problem.

Last Review Date: March 8, 2017