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Fertility services

Tests to Diagnose Male Infertility

It is important to know that 3 out of every 10 times, infertility is due to an underlying issue associated with the male partner. In comparison, the female partner may be responsible for infertility every 4 out of 10 times. Most of the time, infertility is due to a combination of factors contributed by both partners. In certain cases, despite diagnostic tests, the cause(s) for infertility may remain unexplained.

If you are a male, already on or ready to embark on a fertility journey, our specialists at CReATe Durham Fertility may recommend a few diagnostic test(s) post your medical evaluation. These tests may be decided by your age to understand your sperm production and motility, exposure to environmental factors, STDs, hormone imbalances, or complications due to surgery or injury.

What causes male infertility?

Many factors can impact sperm maturation and development. Some of the most prevalent causes of male infertility are as follows:

Sperm Disorders

In many cases, infertility is caused by sperm disorders: the sperm may not be fully developed, may be irregularly shaped, may have low motility, or may not exist at all. In addition to these abnormalities, lifestyle factors such as smoking, consuming alcohol, or medication usage can all impact sperm count, resulting in infertility. Long-term illnesses, childhood illnesses, or hormonal abnormalities can also impact sperm production. Injury or any obstruction or blockage in the reproductive tract could also be a contributing factor to male infertility.

Varicoceles

Varicoceles are the enlargement or swelling of your scrotal veins. They are a common cause of male infertility caused due to non-circulation of the oxygen-depleted blood from the testicles. These enlargements prevent correct sperm drainage by forcing blood to flow back into your scrotum, raising the temperature of the scrotum and reducing sperm count.

Retrograde Ejaculation

Retrograde ejaculation refers to the condition when the semen flows backward into the bladder instead out of your urethra and the tip of your penis during sexual climax. The semen is expected to come out of the urethra, the tube through which sperm and urine both leave the body. Retrograde ejaculation is also called dry orgasm. With this problem, the sperm may return to the bladder rather than the vagina, resulting in sterility. Surgery, drugs, or nervous system complications can all induce retrograde ejaculation. Common symptoms of retrograde ejaculation include cloudy urine after ejaculation and less fluid on ejaculation.

Infertility Due to Immunologic Factors

Male fertility can also be impacted by autoimmune disorders. In some cases, the male body may start producing antibodies against sperm, impacting its production and motility, thereby causing infertility. This autoimmune disorder may be due to an accident, surgery, or infection.

Obstruction

In certain circumstances, the sperm canals may get blocked, impacting male fertility. This obstruction may be caused due to infections, surgery (vasectomy), edema, or congenital abnormalities.

Hormones

Decreased levels of male hormones can impact sperm production, count, quality, shape, and motility, resulting in infertility. Hence your fertility specialist at CReATe Durham Fertility may recommend some blood tests for hormone evaluation.

Medication

Some drugs can impact sperm generation, count, and motility. Cancer, renal illness, arthritis, depression, and high blood pressure medications have all been linked to decreased fertility. Hence you should be clear and transparent about your medical history with your fertility specialist.

How is male infertility diagnosed?

Diagnosing the cause(s) of male infertility is a complicated process. Hence, your fertility specialist may begin with an essential physical evaluation, medical history assessment, and a few hormone and sperm tests.

1. Medical history and general physical evaluation

Your fertility specialist may examine your reproductive organs (genitals) and request some information about your family history of medical conditions, infections, injuries, or operations that may cause infertility. They may also discuss your sexual and lifestyle behaviors.

2. Hormone evaluation

The pituitary gland and brain play essential roles in sperm and hormone production. Your fertility specialist may request an assessment of your testosterone hormone, thyroid-stimulating hormone (TSH), and prolactin levels.

3. Sperm kinetics and sperm analysis

Your fertility specialist may request you to provide a sample of your sperm for analysis. This analysis would include an assessment of the sperm count, shape (morphology), movement (motility), and any infections. This analysis is done in four ways:

  1. Computer-Aided Sperm Analysis (CASA)
    CReATe Durham Fertility has a fully equipped sperm kinetics lab. Computer Assisted Semen Analysis (CASA) assists in evaluating sperm motility, kinetics, and fertilization features such as sperm count, pH, concentration, and shape. This test is funded by the Ontario Health Insurance Plan (OHIP) and may require a scheduled appointment. Sometimes, your sample may be frozen and forwarded to CReATe Fertility Centre Toronto for advanced diagnostic purposes.
  2. Test for Anti-Sperm Antibody (ASA)
    This test detects the presence of specific antibodies (proteins) in sperm samples that may create an autoimmune response against the body’s sperm. If many sperm antibodies encounter the sperm, it may impact egg fertilization, causing infertility. Sperm can trigger an antibody or immune system response in both men and women. Hence this test may be recommended to both men and women. This type of infertility caused due to an autoimmune disorder is called Immunological infertility. This test is funded by the Ontario Health Insurance Plan (OHIP) and may require a scheduled appointment. Sometimes, your sample may be frozen and forwarded to CReATe Fertility Toronto for advanced diagnostic purposes.
  3. Sperm DNA Fragmentation Index (DFI) Test
    Male infertility and pregnancy loss/miscarriage are linked to sperm DNA damage. To determine the male factor causing infertility, the test analyses the structure and integrity of the sperm DNA. The sperm DNA Fragmentation Index (DFI) is helpful in predicting pregnancy success and failure. This test is NOT covered by the Ontario Health Insurance Plan (OHIP) and may require a scheduled appointment. Sometimes, your sample may be frozen and forwarded to CReATe Fertility Toronto for advanced diagnostic purposes.
  4. Fluorescent In-Situ Hybridization (FISH)
    Fluorescence in situ hybridization (FISH) allows researchers to view and map the genetic material in an individual’s cells (sperm), including specific genes or sections of genes. This may be used for understanding a variety of chromosomal abnormalities and other genetic mutations in the sperm. This test helps ascertain the male factor for infertility, especially if there are repeated failures in IVF, ICSI, and miscarriages. This test is NOT covered by the Ontario Health Insurance Plan (OHIP) and may require a scheduled appointment. Sometimes, your sample may be frozen and forwarded to CReATe Fertility Toronto for advanced diagnostic purposes.

Your fertility specialist will recommend assisted reproduction alternatives for pregnancy or parenthood based on your test results.