What to expect during a male infertility evaluation

An infertility evaluation will start with a complete reproductive, medical and surgical history. The doctor will ask about your sexual health and history, past illnesses, fertility treatments, surgeries or testicular exposure to heat, radiation and chemicals.

During the physical exam, a doctor will assess the build, hair distribution, breast development and external genitalia of the patient. The doctor will pay special attention to the size and consistency of testicles and the structures inside the spermatic cord (the series of long tubes that connect the testicles to the body). 

The semen analysis will include:

• Ejaculate volume - how much fluid is in the sample
• Sperm concentration - how many sperm are in the sample
• Sperm motility - how well the sperm can move
• Sperm morphology - the shape of the sperm 

Ideal Results for a Semen Analysis

According to standards set by the World Health Organization (WHO), the ideal semen analysis results include:

• Ejaculate volume: 1.5 to 5.0 mL
• Sperm Concentration: More than 15 million/mL
• Sperm Motility: More than 45% motile
• Total Motile Sperm Count: More than 20 million
• Sperm Morphology: More than 5% normal (using the Kruger Strict system, which rates how likely it is that sperm can fertilize an egg)
• Leukocytes (white blood cells) to look for infection or inflammation
• Anti-sperm antibodies, which the body’s immune system may create in response to sperm
• Reactive oxygen species (free radicals that damage sperm)
• Sperm DNA integrity to see if there is damage to the sperm’s genetic material

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