Male factor infertility is defined as ‘the presence of abnormal semen parameters or sperm functional assays’, or ‘the functional inability to adequately deliver semen into the vaginal canal’, by the male partner of an opposite-sex couple who are unable to achieve conception after trying for 1 year of unprotected intercourse.
Male factor infertility alone contributes up to around 30% of cases of infertile opposite-sex couples and to an additional 30% to 40% in combination with other factors.
Most cases are of unknown causes. However, there are a number of tests that can be done to try to understand the cause. These is the usual pathway for a patient.
History and exams that are usually taken and these consist of:
Key diagnostic factors
- presence of risk factors
- inability of an opposite-sex couple to conceive
- palpable and dilated testicular veins
Other diagnostic factors that are considered:
- headaches, galactorrhoea, and visual disturbance
- frequent respiratory infections
- pain, blood, or pus with ejaculation
- prior chemotherapy or radiotherapy
- current medications
Diagnostic investigations that might be performed include:
Investigations usually consist of:
- sperm concentration
- sperm motility
- sperm morphology
- seminal fluid parameters
Other investigations that are considered:
- sperm viability
- sperm membrane function
- MRI of the pituitary and hypothalamus
- hormonal assays
Assisted reproductive techniques such as TESA, PESA and MicroTESE are often the fastest and most effective method to achieve pregnancy regardless of the cause of male factor infertility.
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.