The reasons for various Investigative Procedures
(In)fertile? |
If there are less than 5 million sperm cells per ml of ejaculate, the man has a pronounced fertility problem. |
Normozospermia |
An ejaculate of at least 2ml, containing a minimum of 20 million sperm cells per ml, or a minimum total of 40 million sperm cell, of which 50% are motile and at least 30% are of normal shape. |
Azospermia |
Absence of sperm cells in the ejaculate. |
Investigations into male factor infertility aim to establish the root cause of infertility. They include physical examinations, blood tests, image forming techniques, laboratory analysis and sperm samples. See the
overview list for further information over the different investigations.
There are many causes of male infertility, which can largely be divided into four groups:
- pre-testicular causes
This means disturbances in the hormonal impulses which come from the brain or adrenal glands, which also play a hormonal role. An example of hormonal imbalance is 'Kallman syndrome': An absence of certain structures in the hypothalamus, making the production of GnRH impossible. Men with this condition are not only infertile, but they have no sense of smell either. - testicular Causes
Refers to problems located in the testicles, where sperm is made. The problem can originate - although not genetically determined - from the development of the testicles, or at a later stage. We refer to the latter as 'acquired abnormalities', such as varicose veins in the testicles. - post-testicular causes, past the testicles
The problem can be physical (e.g. obstructions in the epididymis or vas deferens) and not genetically determined, such as after an infection of some sort. Genetically determined abnormalities may include an absence of the vas deferens at birth. The cause could also be 'functional' like impotence for example. - other causes
These include infectious (sexually transmitted diseases) and immunological causes, such as when the man produces antibodies against his own sperm.
Blood tests [blood test | lab]
Every fertility treatment is preceded by a series of blood tests for men and women alike (see
practical aspects of investigations). These are performed for the following reasons:
See preliminary investigations (p. 2).