Even before my husband and I began to try to have children I knew that I could have fertility issues. I annually (at first) saw a gynecologist and had times when I turned to him for consult regarding one female issue or another. I was aware that I had irregular periods, heavy bleeding and painful cramping – all signs that female fertility problems can be present. My husband, on the other hand, had no real indication of if he could have a problem or not. He did not see a physician regularly and had no occasion to visit a doctor that could or would diagnose problems that could affect fertility. So, after a year of trying to conceive with no success, my doctor suggested that I send my husband for fertility testing since we had no idea if he also had issues that were contributing to our trouble.
I am a big advocate for making sure that the male partner in a couple having trouble conceiving get tested early on in the process. The initial testing for the male is relatively simple whereas female testing is often invasive, physically uncomfortable and often more expensive. Even if the female already knows that she may have issues that are hindering conception, it is also very important to learn if you as a couple in fact have male and female issues. Up to thirty percent of the time a man’s low fertility is the primary obstacle to conception. Typically the first step for the male in a couple having trouble getting pregnant is for him to visit a urologist.
At this initial appointment with the urologist the male will often be asked to provide a semen sample and the doctor will perform a physical exam, ask questions about lifestyle and sexual history and do a thorough review of his full medical and reproductive history. The sperm and semen will be analyzed basically looking at volume and count, morphology (the shape of the sperm)and motility (how they move). Sometimes there are no sperm at all present which is called azoospermia and could indicate a blockage not detected by the physical examination. Varicocoeles, abnormal formations of veins above the testicles, are the most common cause of correctable male infertility which can be treated with surgery and are most often found when a male is first pursuing fertility testing.
My husband did not put up too much of a fight about getting tested. He did manage, though, to put it off for way longer than I liked! When he finally got tested he was actually relieved to learn that things were not as bad as he thought. He had convinced himself that not only was I bringing a lot of issues to the table in terms of fertility, but that he would also have problems and our chances of conception would be even smaller. He was relieved to learn that for the most part his analysis was normal. The tests revealed that he did have mild antisperm antibodies, or abnormal antibodies that some men make that attack the sperm on the way to the egg preventing fertilization. Luckily, this was an easily correctable problem since we were already slated to undergo fertility treatment for my issues – prior to the IVF procedure his sperm sample was “washed” which is supposed to help eliminate the antibodies. Thorough testing made us more informed, better equipped to deal with our issues, and responsible in our efforts to find out why we were having trouble conceiving. In fact, with thorough testing of both the male and female up to eighty five percent of couples can identify the cause of their fertility issues making treatment more targeted and appropriate and often more successful.
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