screening for male infertility

Overview

Male infertility screening is a group of checks and tests used to find out whether a man’s sperm or reproductive system is making it harder for a couple to get pregnant. It is usually considered after a couple has been trying to conceive for one year without success, or earlier if there are known risk factors.

Yes. Infertility is common, and male infertility is involved in roughly half of all couples who have trouble conceiving.

Male infertility screening affects adult men who are trying to have a baby with a partner. It can happen at any age after puberty, but fertility naturally declines with age.

Symptoms

Common symptoms

• Difficulty conceiving after one year of regular, unprotected sex
• Low interest in sex or erectile dysfunction
• Pain, swelling, or a lump in the testicle area
• Reduced facial or body hair
• Abnormally small or firm testicles

Causes

Main causes

• Low sperm count or no sperm at all
• Sperm that are shaped abnormally or cannot swim well
• Blockages in the tubes that carry sperm
• Hormonal imbalances, such as low testosterone
• Genetic conditions, such as a missing piece of the Y chromosome
• Infections that damage reproduction organs

Risk factors

• Getting older, particularly after age 40
• Smoking or using tobacco products
• Drinking too much alcohol
• Using recreational drugs, such as marijuana or anabolic steroids
• Being overweight or obese
• Exposure to chemicals, radiation, or extreme heat
• Having undescended testicles as a child
• Having certain infections, like mumps as an adult
• Taking certain medicines that can affect sperm (talk with your doctor about this)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe testicular pain or an injury, seek urgent care immediately.
• If you notice a new hard lump in a testicle, make an urgent appointment.

Book a routine appointment if:

• See a healthcare provider if you and your partner have not conceived after one year of regular unprotected sex.
• Seek advice earlier if the woman is over 35, or if you have known risk factors such as a past testicular injury or surgery.

Diagnosis

A doctor will ask about your medical history, lifestyle, and any previous pregnancies. They will also do a physical exam of the testicles and penis, then order a semen analysis to assess sperm count, shape, and movement.

Tests that may be done

• Semen analysis — the main test for sperm health
• Physical examination of the genitals
• Blood tests to check hormone levels, such as testosterone and FSH
• Genetic tests, if a genetic cause is suspected
• Ultrasound to look for blockages or varicoceles
• A urine test to check for infections

What to expect at your appointment

You will be asked to provide a semen sample, usually by masturbating into a sterile cup in a private room at the clinic. You may need to avoid ejaculating for 2 to 5 days before the test. If the result is unclear, the test may be repeated. Most tests are painless and take about an hour in total.

Treatment

Treatment depends on the cause of infertility. It can include lifestyle changes, medicines, surgery, or assisted reproduction techniques that help couples conceive.

Self-care at home

• Keep a healthy weight
• Stop smoking and avoid secondhand smoke
• Limit alcohol to a moderate level
• Avoid illegal drugs and anabolic steroids
• Keep the testicles cool by avoiding hot baths, saunas, or tight underwear
• Reduce stress through exercise, hobbies, or relaxation

Medical treatments

Your doctor may recommend medicines to correct hormone problems or to treat infections that affect fertility. For many couples, assisted reproductive techniques such as intrauterine insemination (IUI), in vitro fertilisation (IVF), or intracytoplasmic sperm injection (ICSI) can help achieve pregnancy. Your medical team will discuss the best approach for your individual situation.

When is surgery considered?

Surgery may be an option to repair a blocked tube or to remove a varicocele, an enlarged vein near the testicle that can affect sperm quality. In some cases, sperm can be removed directly from the testicles through a small procedure for use in assisted reproduction.

Living with this condition

Living with infertility can be emotionally heavy for couples. Talking openly with your partner and keeping a shared perspective can reduce stress. Try to attend appointments together and support each other.

Lifestyle tips

• Eat plenty of fruits and vegetables
• Include foods rich in antioxidants, like berries and nuts
• Avoid smoking and recreational drugs
• Stay physically active but avoid overtraining
• Minimize stress and get enough sleep
• Wear looser-fitting underwear if heat may be an issue

Diet and exercise

A balanced diet with healthy fats, proteins, and a variety of vegetables may support sperm health. Regular, moderate exercise—like brisk walking or swimming—is better than extreme endurance training, which can sometimes affect sperm production.

Mental health and emotional wellbeing

Infertility can cause anxiety, depression, low self-esteem, and feelings of guilt. These feelings are very common. It is important to acknowledge them and seek help from a counsellor or support group.

Prevention

Not all causes of male infertility can be prevented, but you can reduce the risk of some types of damage by protecting your testicles during sport, avoiding risky behaviours, and catching infections early.

Screening programmes

Routine screening for male infertility is not recommended for everyone. Screening generally happens when a couple is struggling to conceive. However, men with certain risk factors—like a history of undescended testicles or a previous testicular surgery—may be evaluated earlier.

Complications

If left untreated

• A couple may continue to struggle to conceive without knowing the reason.
• An underlying condition, such as a hormonal problem or a small tumour, may go undiagnosed.
• Emotional stress on the relationship can increase without proper support.

Long-term outlook

Infertility is a medical condition, not a personal failure. With today’s tests and treatments, many men can become fathers. Even when natural conception is not possible, options such as IVF, sperm donation, or adoption exist. Talking to a healthcare team gives you clarity and hope.

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