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Fertility Is Not Just About the Female

Takes two

When a couple is having trouble conceiving, the woman usually she goes to her health care provider for evaluation. Obviously, the woman carries a pregnancy, but it actually takes two to tango! A male factor is found in about half of couples for which a cause is identified. For that reason, both the man and woman must be willing to undergo evaluation and treatment.

Since the gametes of the male are fairly easily accessible, one of the first steps in an infertility evaluation should be a semen analysis. The man should abstain from ejaculation for at least two days, but not more than seven days prior to testing. His sample should be collected by masturbation into a specially tested specimen container and must be received by the laboratory within 30 to 45 minutes after collection. Our practice has a special room for sample collection, but if you live close enough, he can collect the sample at home. The male must bring in his own sample with a government-issued photographic identification. Results are usually available the same day.

If the semen analysis is abnormal, the test is generally repeated a few weeks later. If it is still abnormal, laboratory evaluation may be performed. We recommend that men with abnormal semen analyses undergo comprehensive evaluation by a specially trained urologist. Men with abnormal semen analyses have a slightly increased risk of testicular cancer, so the urologist will look for signs of that, as well. Sometimes medications can be given to improve semen quality.

One of the most common reasons for an abnormal semen analysis is the use of supplemental testosterone. Even small amounts of testosterone (oral, on the skin, or injections) can lower sperm counts significantly, even to zero! Furthermore, it can several months for the sperm counts to return to normal, and in rare cases it never does. Take home message -- do not take testosterone if you plan to father a pregnancy! Other medications can also have a negative impact on the semen analysis. Be sure to tell your healthcare provider ALL of the medications you are taking, including those available over-the-counter.
There are other causes for abnormal semen analyses besides just medications. Some of these causes include genetic abnormalities, abnormalities in the male reproductive system, hormonal problems, and for some men with abnormalities, no cause can be found.

Knowing the results of the semen analysis will help guide your healthcare provider in the best treatment for you. Pregnancy can still be achieved even with very low sperm counts.

To find out more about your fertility and reproductive options, please call our office at 205-307-0484 to schedule an appointment to see one of our providers. We are here for you! 

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.