What is infertility?

Infertility refers to the failure to conceive after regular unprotected sexual intercourse for two years in the absence of any known reproductive pathology. As there is often more than one cause of infertility, the fertility specialist would want to see both you and your partner. It may take several tests to determine the cause of infertility. In some cases, a cause is never identified.

Diagnostic tests for male infertility

If male infertility is suspected, a semen analysis is performed. This test will evaluate the health of your sperm. A blood test may also be performed to check your level of testosterone and other male hormones.

General physical examination and medical history

This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Your doctor may also ask about your sexual habits and your sexual development during puberty.

Semen analysis

Semen samples can be obtained in different ways. You can provide a sample by masturbating and ejaculating into a special container at the doctor's rooms. However, because of religious or cultural beliefs, some men prefer an alternative method of semen collection. In such cases, semen can be collected by using a special condom during intercourse.

Additional tests

Further tests may be done to help identify the cause of your infertility, including:

  • Scrotal ultrasound

  • Transrectal ultrasound

  • Hormone testing

  • Post-ejaculation urinalysis

  • Testicular biopsy

  • Specialised sperm function tests

Treatment for male infertility

Even if an exact cause isn't clear, your doctor may recommend treatments or procedures that could lead to conception. Your doctor may also recommend specific treatments for your partner. Or, you may be advised that assisted reproductive techniques is appropriate in your situation.

Treatments for male infertility include:

Surgery

A varicocele can, for example, often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. In cases where no sperm are present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis.

Treating infections

Antibiotic treatment might cure an infection of the reproductive tract but doesn't always restore fertility.

Treatments for sexual intercourse problems

Medication or counselling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.

Hormone treatments and medications

Your doctor might recommend hormone replacement or medication in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.

Assisted reproductive technology (ART)

ART treatments involve obtaining sperm through normal ejaculation, surgical extraction, or from donor individuals — depending on your specific case and wishes. The sperm are then inserted into the female genital tract, or used to perform in vitro fertilisation or intracytoplasmic sperm injection.