Male infertility is referred to as a sexually active man’s inability to get his spouse pregnant even after trying for over a year. Nearly 1 in 7 couples is infertile, which means they haven’t been able to conceive a child even though they’ve had frequent, unprotected sexual intercourse for a year or longer. In up to half of these couples, male infertility plays at least a partial role.

Male infertility usually stems from low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Also, Illnesses, injuries, chronic health problems, lifestyle choices and other factors may contribute to male infertility.

What Causes Male Infertility?

The main sign of male infertility is the inability to conceive a child. an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes signs and symptoms. Signs and symptoms you may notice include:

• • Sperm disorders (problems with the sperm shape, growth, movement, and overall count)
  • Varicoceles (a problem characterized by swollen veins in the scrotum)
  • Retrograde ejaculation (a problem causing the semen to move to the bladder instead of ejecting from the penis after a man reaches the climax)
  • Hormonal imbalance (lower levels of the hormones that tell testicles to produce sperms)
  • Immunologic infertility (a condition caused by antibodies attacking sperms in the body)
  • Obstruction (blockage in the tubes responsible for transporting sperms due to swelling or other defects)
  • Changes in Chromosomes or DNA molecules
  • Medication (Medicines used to treat depression, anxiety, digestive problems, infections, cancer, and high blood pressure)

Diagnosing male infertility can be complicated and involve an extensive process of elimination, exploring and excluding all “likely suspects” until a definitive cause is found, which including

• Medical Historyreviewing your medical history to determine if you have (or have had) any diseases, conditions, or treatments that could contribute to male infertility.These include testicular or penile injuries, heavy alcohol or drug use, prior radiation or pelvic surgery, or medications that contribute to sexual dysfunction or male hypogonadism. Your sexual practices would also be discussed. 
• Physical ExamThe physical exam should involve a comprehensive examination of your penis, scrotum, testicles, vas deferens, urethra, and lower abdomen. A tool called an orchidometer may be used to measure the volume of your testicle to check for discrepancies in sexual development.A digital rectal exam (DRE) may also be performed. This involves the insertion of a gloved finger into the rectum to check for problems with your prostate gland. 
• Semen AnalysisA spermiogram is typically the tool used to investigate male infertility. Also known as a semen analysis, the test evaluates the number and quality of the spermatozoa (sperm cells) along with their shape, size, and motility.
• Lab Tests and ProceduresVarious lab tests and procedures may be ordered to check for the underlying causes of male infertility, including:Hormone tests: Used to check for imbalances in testosterone and other hormones in the blood.Genetic tests: Used to detect genetic disorders like Klinefelter’s syndrome or cystic fibrosis.STI screening panel: Used to detect sexually transmitted infections in blood and/or urine.

  Post-ejaculation urinalysis: Used to detect sperm in your urine due to retrograde ejaculation.

  Testicular biopsy: Used to obtain a tissue sample from your testicle to check for problems with spermatogenesis (sperm cell production)

  Sperm FISH: Used to check for sex chromosome abnormalities in sperm cells using a technology known as fluorescent in situ hybridization (FISH)

   

   

• Imaging StudiesThe main imaging tool used to diagnose male infertility is a Ultrasound. The noninvasive test uses high-frequency sound waves to generate images of internal organs and tissues.There are different types may use:Scrotal ultrasound: Used to check for abnormalities in the testicles, epididymis, and vas deferens.Transrectal ultrasound: Used to check inside the rectum for abnormalities of the prostate gland and nearby structures.