How is Male Fertility Evaluated?

The first step in evaluating the male is the basic semen analysis. It is recommended to have at least 2 tests performed 2-6 months apart, but if the first test results are well into the normal range it is acceptable to postpone the second test and move to other testing as discussed below. Conclusions should never be made off of one semen analysis test due to the variability each man may have in addition to laboratory and specimen handling issues. A result below normal limits is a good time to get serious about health and implement healthy lifestyle changes. Any significant change however will take at least 3 months to show effectiveness. This is because there needs to be time for the body to adjust, then it takes 70-75 days for spermatogenesis, and up to 10 days for maturation of sperm in the epididymis.

The basic semen analysis should include:

• Volume, pH, color, viscosity, agglutination, and time to liquefaction
• Count per ml and per ejaculate
• Motility
• Progressive motility
• Morphology
• Count of round cells and staining for WBC’s when round cells exceed 4 per high power field.
• Speed of sperm movement
• Vitality when motility is < 30%

     Additional testing would include a scrotal ultrasound to look for anatomic abnormalities, a basic hormonal profile and other sperm function testing. More information will be provided on these specific topics in another section.