Symptoms of male infertility

The male factor is known to be the cause of infertility in about 45% to 50% of infertile couples. Reduced fertility in males can occur due to various reasons and accordingly the symptoms manifested may be different. Here are some symptoms of male infertility:

1. If the partner does not conceive after a year of attempting to conceive, one must investigate both partners.
   
   
2. Examination of the male reproductive system may indicate the presence of undescended testis or tumor or Varicocoele which needs to be addressed either surgically or medically.
   
   
3. Some of the genetic abnormalities have typical physical appearance like feminization ,absence of secondary sexual characteristics, small hard testes etc
   
   
4. Erectile dysfunction may be the primary symptom of an underlying condition of either the vasculature or the nerve supply.
   
   
5. Loss of sexual desire is another symptom that points towards reduced fertility with underlying causes like a hormone imbalance or depression
   
   
6. Another pointer towards is difficulty in urination or ejaculation. The likely cause could be the abnormal opening of the urethra on the underside (hypospadias) or on the dorsum of the penis (epispadias). Hypospadias are likely to cause retrograde ejaculation and hence presence of milky white urine after an orgasm needs further investigation.
   
7. Blurring of vision with abnormal hormonal profile along with a computerized tomogram (CT) scan showing enlarged pituitary glands may suggest the presence of a pituitary tumor which needs surgical removal.
   

Diagnosis of male infertility:

The first and the most important test to determine male fertility is a semen analysis. This test must be performed after a period of abstinence of 3days for optimum results. According to the World Health Organization (WHO) a sperm count of less than 20 million per ml of semen is considered to be oligospermic and such an individual’s partner is likely face difficulty in conceiving. It is not only the sperm count that is important but morphological abnormalities of the sperms are also important. The different abnormalities could involve the head of the sperm which is important for the penetration into the ovum.

Other abnormalities may include the neck or the tail of the sperm. The motility of the sperms is another important criterion taken into consideration. A defect in the forward progressive motility is again likely to contribute to reduced fertility in the male. Absence of sperms (Azoospermia) in the semen and the presence of mature sperms testes confirmed by a needle biopsy is likely to be due to a blockage in the ejaculatory ducts. A thorough medical examination can reveal cryptorchidism or variococoele or hypospadias. A hormone analysis may be required to identify the cause of infertility.

There is a likely reduction of the male hormone testosterone or there male be an increase in the Follicle Stimulating Hormone (FSH) in some patients. A good ultrasonography or a CT scan is very helpful in identifying local causes of male infertility. In some conditions antibodies are produced against the sperms which destroy them.  Agglutination of sperm in such cases is likely to identify the presence of autoantibodies against the sperms or an infection. Sperm immobilization tests are performed in the laboratory to determine the capacity of the sperm to swim towards the ovum in vivo.

References:
http://www.testsymptomsathome.com/SYM_male_infertility.asp
http://www.gettingpregnant.co.uk/male_infertility_symptoms.html
http://www.hmc.psu.edu/healthinfo/m/maleinfertility.htm