Man and Fertility: As Simple as it Gets

Posted on by Paul Turek, MD

Evaluating men for infertility is a really a slice of the same pie. It appears complex but it doesn’t have to be. Is infertility frustrating? For sure. You’re both young, you’re both healthy, your timing is good, and things feel right. So why the hell isn’t it happening? Take a moment to breath and realize that you’re not alone in this and that good care is here.

Love Made Visible

Like with cooking, start simple. Begin with him, as he is part of the problem in half of infertility cases. Not only that, the male evaluation can often be done in a single office visit. Here’s what it involves:

  • A medical history. Done right, this can reveal a host of risk factors including childhood surgeries, obesity or diabetes, toxic medications or habits like pot, baths or tobacco, and occupational issues such as radiation, solvents or excessive travel. Even sex lubricants need evaluation.
  • A physical exam. Poo-pooed in medicine as being useless, a 1-minute examination of men for infertility can be utterly invaluable. With penile hypospadias, the semen may not land where it needs to. Testis size can tell us a lot about sperm production. A clinical varicocele, unique to our species, is the most common (and correctable) cause of impaired semen quality. And if the sperm conducting tubes are missing, well there’s your answer.
  • Two semen analyses. Every guy gets these but unless they read “0,” semen analyses are a terrible predictor of fertility. One reason is that couples don’t need a “normal” semen analysis to conceive. They can often do just fine with less. Not only that, just looking at the numbers tells us little very little about how well sperm work. But the semen analysis is a great place to start because it can suggest directions to take and it can also reflects on a man’s current and future health
  • Blood tests. Blood draws aren’t fun but here they can be valuable for finding benign brain tumors (prolactin), low testosterone states, and genetic causes of male infertility. Good to know that most hormonal issues are correctable, although genetic conditions are not. Either way, good information leads to solutions.

You’d be amazed what can be learned about a couple’s infertility after taking this simple step. Maybe a lifestyle issue is tweaked or correctable condition is treated. Maybe things are found to be genetic and technology is recommended. Or maybe <a href="http://www.jurology.com/article/S0022-5347(15)02985-7/pdf" target="_blank" rel="noopener
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