It seems the female is usually the de-facto cause of infertility. However, this is a common misconception. Male infertility is estimated to be to blame for 40-50% of infertile couples. It is estimated that 5-10% of all married men have some degree of male infertility.
If you have been trying to conceive for 1 year (or 6 months if 30 years+) you should start by seeing your primary care doctor and asking for a semen analysis. This test is very inexpensive and non-invasive. Since this test is so easy, it is recommended to start with the male before moving onto female infertility. Once your general doctor looks at the results of the semen analysis, he may refer you to a specialist if the results come back abnormal in any way.
You can look at the results of the semen analysis to get more information. Below is a chart that classifies semen analysis results as either fertile, infertile, or sub-fertile. Fertile means there is optimal chance of fertilization; Sub-fertile means there is reduced chance of fertilization and infertile means very small chance of fertilization.
| Infertile | Sub-fertile | Fertile | |
|---|---|---|---|
| Concentration (x10^6/mL) | <2.0 | 2.0-9.9 | >10.0 |
| Motility | <10 | 10-29 | >30 |
| Forward Progression | <1.0 | 1.0-1.9 | >2.0 |
| Motility Index | <20.0 | 20.0-49.9 | 50.0> |
| Morphology | <5 | 5-14 | >15 |
| Volume (mL) | <1.0 | >6.0 1.0 | 6.0 |
Another test the doctor may run is a sperm penetration assay. This will determine if the sperm are able to fertilize an egg. This test is actually done with hamster eggs, and how well the sperm penetrates the hamster egg will tell the doctor if the sperm can fertilize human eggs. These tests are not perfect, though. Some times the the results come back negative, yet the sperm are still able to penetrate the egg their partner's eggs.
A new test that is now available takes a deeper look at the sperm. It is called a sperm DNA integrity assay (SDIA) and it will tell if the DNA of the sperm are normal.
If you find that the male partner has male infertility it is still necessary to check the female partner's fertility because it is possible both partners have some degree of infertility. If your results do come back indicating male infertility, this does not mean you cannot conceive. Sometimes procedures are necessary to increase male fertility. Varicoceles, prostate problems, hormone problems can all cause male infertility. There is also the option of artificial insemination, which can often compensate for male infertility issues. It is important to remember that in this age of technology, do not loose hope - there are options out there. For more information on treatment options go to treatment.