University of California San Francisco | About UCSF | UCSF Benioff Children's Hospital San Francisco
Search Site | Find a Doctor

Infertility in Men
Diagnosis

An initial male fertility examination includes a medical history, physical examination, general hormone tests and one or more semen analyses, which measure semen volume as well as sperm number, ability to move spontaneously and quality of motion.

Medical History

Initial questions may include:

  • A review of past medical history, prior surgeries and medications used
  • A discussion of family history of infertility or birth defects
  • A careful review of social history and occupational hazards to evaluate potential exposure to hazardous substances that could impact fertility

Physical Exam

Next, you will receive a thorough physical examination to evaluate the pelvic organs — the penis, testes, prostate and scrotum.

Laboratory Tests

Laboratory tests may include:

  • Urinalysis — These can indicate the presence of an infection.
  • Semen Evaluation — The evaluation assesses sperm motility or movement, the shape and maturity of the sperm, the volume of the ejaculate, the actual sperm count and the liquidity of the ejaculate.
  • Hormonal Tests — Hormonal tests evaluate levels of testosterone and FSH (follicle-stimulating hormone) to determine the overall balance of the hormonal system and specific state of sperm production. Serum LH and prolactin are other hormonal tests that may be done if initial testing indicates the need for them.

If a diagnosis is not obvious after the initial evaluation, further testing may be required. One or more of the following tests may be recommended:

  • Seminal Fructose Test — To identify if fructose is being added properly to the semen by the seminal vesicles
  • Post-ejaculate Urinalysis — To determine if obstruction or retrograde ejaculation exists
  • Semen Leukocyte Analysis — To identify if there are white blood cells in the semen
  • Kruger and World Health Organization (WHO) Morphology — To examine sperm shape and features more closely
  • Anti-sperm Antibodies Test — To identify the presence of antibodies that may contribute to infertility
  • Sperm Penetration Assay (SPA) — To confirm the sperm's ability to fertilize
  • Ultrasound — To detect varicoceles (varicose veins) or duct obstructions in the prostate, scrotum, seminal vesicles and ejaculatory ducts
  • Testicular Biopsy — To determine if sperm production is impaired or a blockage exists
  • Vasography — To check the structure of the duct system and identify any obstructions
  • Genetic Testing — To rule out underlying mutations in one or more gene regions of the Y chromosome, or to test for cystic fibrosis in men missing the vas deferens

After the diagnostic evaluation is completed, treatment may involve medical or endocrinologic treatment, surgical correction or a decision to manipulate or process sperm to achieve a pregnancy.

Reviewed by health care specialists at UCSF Medical Center.

Related Information

UCSF Clinics & Centers

Reproductive Health

Center for Reproductive Health
2356 Sutter St., Seventh Floor
San Francisco, CA 94115
Phone: (415) 353-7475
Fax: (415) 353-7744
Appointment information

Male Reproductive Health Center
2356 Sutter St., Third Floor
San Francisco, CA 94115
Phone: (415) 353-3076
Fax: (415) 885-3663
Appointment information

Related Conditions