What to Expect from a Fertility Workup – The Guys Edition

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Per the American Society of Reproductive Medicine, infertility affects women and men equally.

About 33 percent of infertility cases can be attributed to male factors, 33 percent to female factors, and one-third to a combination of problems in both partners or unexplained causes.

However, male infertility isn’t talked about as much, and we’re aiming to change that! Why? Because male testing is generally noninvasive and faster, which can provide quicker insight into the causes of the infertility issues a couple may be having. This is why ideally, both partners should pursue a fertility work-up to gain the most insight. So ladies, share this one with the man in your life, and men, read on!

To review, here’s the rule of thumb regarding when you should see a fertility specialist:

  • If the female partner is under the age of 35 and you have been trying to conceive for at least one year
  • If the female partner is over 35 and you have been trying to conceive for at least six months

Even though the guidelines are based on the woman’s age, it takes both sperm and egg to make a baby, so either (or both) can play a role in fertility issues.

While some men may feel embarrassed about seeing a fertility doctor (also known as a reproductive endocrinologist or RE), there’s no need to be. In fact, you’re being proactive by   meeting with a specialist who can identify medical issues that may exist and discuss available treatment options. An RE may also refer you to a urologist, who is a physician dedicated to the area of urology and male reproductive health.

Upon your initial visit with an RE or urologist, the doctor will take your personal and family medical history. Here are a few red flags the physician will be looking for:

  • If you’ve ever had cancer and/or chemotherapy treatments
  • Hormone issues or imbalances
  • Infections in the testicle (orchitis), the prostate (prostatitis), or elsewhere in the body that causes a fever
  • Use or past use of certain medications such as anti-seizure medicines
  • An undescended testicle
  • Varicocele which is an abnormal collection of bulging veins above the testicle
  • Genetic abnormalities

Since we’re a genetics company, we figured we’d delve a little deeper into the possible genetic causes of infertility. The three most common genetic tests an RE will conduct are (1) a karyotype, used to detect if a person has the appropriate number and overall structure of chromosome material, (2) Y chromosome microdeletion test, used to determine if genetic information is missing specifically from parts of the Y chromosome that are necessary for normal sperm production, and (3) cystic fibrosis genetic testing, used to uncovered variants in the CFTR gene that can affect male fertility.

The doctor will then perform a physical exam as well as a semen analysis, which primarily looks at three main factors:

  • Sperm Count
  • Morphology (the shape of the sperm)
  • Motility (how well it swims)

Even if the test results come back as “normal”, some doctors may still ask for a second test just to confirm.

If the test comes back with any concerns, the doctor may then perform additional tests such as hormone testing (blood work), a testicular biopsy, and/or genetic testing. This is all to properly diagnose the problem so that a treatment plan can be tailored to you and your partner’s family building goals.

Ultimately, there’s nothing to be afraid of as male factor fertility is quite common and often treatable. Depending on the specific diagnosis, some options may include repairing and blocking off abnormal veins, medication to correct any hormonal imbalances, and surgery to correct obstructions of the sperm passage.You may also have fertility treatments available to you such as intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

The important thing is that by visiting a fertility specialist, you and your partner are taking the first step towards finding the best path to parenthood for you!

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CooperGenomics

Together as part of the CooperSurgical family, we are the pioneers and global leaders of comprehensive reproductive genetic testing. Through expanded carrier screening, PGD, PGS, NIPS and beyond, our team is committed to advancing the field of reproductive genetics, improving outcomes, and empowering families worldwide.

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