Why should the man be tested first during INFERTILITY TREATMENT?
What increases a man’s risk of infertility?
A man’s sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:
- Heavy alcohol use
- Smoking cigarettes
- Environmental toxins, including pesticides and lead
- Health problems such as mumps, serious conditions like kidney disease, or hormone problems
- Radiation treatment and chemotherapy for cancer
In the past, infertility was blamed wholly and solely on the woman. This may have been to protect the fragile male ego, was because the male psyche equates fertility with virility, and views failure to father a child with shame. Studies today however show that 40% of infertility is because of a medical problem with the man.
The vast majority of men have simply no way of judging their fertility before getting married (unless, of course, they have had a premarital affair and fathered a pregnancy – the ultimate proof of male fertility ! Rarely, however, some men may know they have a fertility problem – for example, a sexual problem of impotence, which prevents consummation of the marriage; or one of hypospadias (in which the urethra is located at the base of the penis and the semen cannot be put in the vagina); or undescended testes (in which both the testes are not in the scrotum).
When testing a couple for infertility, the man must always be tested first. Tests for the woman are far more complicated, invasive and expensive – it is much simpler to find out if the man has a problem.
Initial Male Infertility Evaluation
Doctors arbitrarily diagnose infertility when a couple hasn’t conceived a child after 12 months of unprotected and frequent sex. Impaired fertility may be a better description; many couples who keep trying will get pregnant in the second year or later.
A visit to a urologist should start the evaluation for male infertility. The urologist will likely begin with a basic interview and exam:
- A full medical and reproductive history, along with any surgeries you’ve had and medications you’re taking.
- Lifestyle questions, including exercise, smoking, and drug use.
- Physical exam.
- Frank discussion about your sexual life, including any problems with sex or previous sexually transmitted diseases.
In any evaluation for male infertility, the man will need to provide a sample of semen for analysis. The doctor will want the man to give the sample there, or at least someplace nearby, since it’s important that the analysis take place quickly.