What is Unexplained Male Infertility?

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Infertility is something that can occur in men and women. A couple is seen to be infertile when they struggle to conceive after having regular unprotected intercourse for over a period of 12 months. Infertility doesn’t have to be the end of a couple’s pursuit to have a child. There are other options to consider and even ways to possibly improve one’s fertility.


Test for Male Fertility

Testing for male fertility involves a range of methods designed to assess reproductive health and identify any potential issues that may affect fertility. From convenient self-testing kits to comprehensive physical examinations and laboratory analyses, various approaches are available to evaluate male fertility. Here, we explore the different testing options and procedures commonly used to assess male fertility and diagnose any underlying conditions.


Self-Testing Kits

Males can test their fertility in various ways. The most popular first option is a self-testing kit. Although it is convenient, there is still a chance that the kit is not able to provide all the information of a male’s fertility and thus recommended to go to a doctor to test their fertility.


Physical Examination

A doctor will perform a physical examination and examine the testes feeling for any abnormalities like a lump or a nodule. The examination can also include having a look at the patient’s vitals and performing some simple screening tests. Thereafter a thorough history will be taken by asking questions such as if the patient is currently on any medications, whether have they had surgery in the past or if they are even diagnosed with a Sexually Transmitted Infection (STI).


Semen Analyses

This is the most common test that doctors use to test a male’s fertility. It is done by providing a semen sample that is sent to the laboratory. The laboratory will test certain parameters such as the semen volume, sperm count, sperm motility and structure as well as the pH level. If one or more of these parameters are out of range, it can be an indication of infertility or fertility problems and further investigation is needed to conclude what might be causing these parameters to be out of line and how to possibly correct them or treat the patient.


Hormone Test

Usually, a hormone test is also required along with a semen analysis, or when the semen analyses has been inconclusive. The hormone test is implemented by taking a blood sample and sending it to the laboratory. The laboratory will test certain hormones, usually Testosterone levels and Follicle-Stimulating Hormone (FSH) levels. This can give an indication if these hormones are within range and if not, that it might be the cause of a patient's infertility.


Other Tests

Several other tests might be required when the above-mentioned tests have inconclusive results. Some of these tests include a scan of the scrotum and rectum to examine for any torsions, genetic and antibody testing, a prostate exam and the last resort is usually a biopsy.


Unexplained Male Infertility

A male is classified with unexplained infertility when he is still infertile whilst his semen analyses are normal and within range, his history and physical examination also pose no threat and that also includes when the female partner’s infertility factor has been ruled out.

Although semen analysis is the most common and popular test to rely on when testing a male’s fertility, it is not the only factor to consider when a male has unexplained infertility. Semen analysis includes sperm concentration, morphology and movement, but it has limitations as it does not account for any defects in sperm function. Thus sperm function tests should be included in these individuals where it will test things like the transportation of sperm and its interaction with cervical mucus.

When a male has unexplained infertility, it is crucial to include a thorough clinical and physical examination, an in-depth history taking, as well as appropriate endocrine, genetic and antibody tests and examinations.


Causes of Unexplained Male Infertility

Various factors can contribute to unexplained infertility. The factor of immune infertility is one to consider. The immune system and sperm are separated from each other by the blood testis-barrier. When this barrier is broken, the immune system will see the sperm as a foreign body and will attack it. Another factor of cause can be genetic defects on a cellular level within the sperm. It can be chromosomal defects or a disruption of the DNA within the sperm.

An interesting cause is fertilisation defects. The fertilisation process is extremely complex, but when there is something wrong anywhere in this process, it can cause problems with conceiving and lead to infertility.


Options to Consider

When faced with fertility challenges, exploring various treatment options can provide hope and possibilities for conception. Below, we delve into these methods, their procedures, and their potential to address different fertility issues, offering insight into options available on the journey to parenthood.


In Vitro Fertilisation (IVF)

IVF is a common term used more frequently in society. This is an artificial insemination process that requires the female’s eggs to be exposed to the male’s sperm outside of the body and in an incubator. After spending a few days in the incubator, the eggs will be placed in a woman’s womb and a pregnancy test can be taken within 2-4 weeks to see if the insemination process worked. 

This is a possible way to overcome unexplained male infertility when the causes of a male’s infertility are poor sperm motility or a poor reaction that sperm have with cervical mucus. A neutral environment is created hoping for the insemination to take place.


Intra-Uterine Insemination (IUI)

IUI is also an artificial insemination process and requires a sperm sample to be collected and placed directly into the uterus of a female. This can possibly overcome a male’s unexplained infertility. Placing the sperm directly into the uterus, allows sperm to be closer to an egg to inseminate it and can overcome sperm motility barriers.

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