Sperm tests
Sperm testing is a key part of any fertility investigation, and this is usually one of the first tests carried out along with the blood tests. The man produces a sample of semen by masturbation, which is collected in a small pot for analysis in a laboratory. The sample may have to be produced at the hospital, and most fertility clinics have special rooms for this purpose. The idea of performing to order in a back room at the clinic with a few erotic magazines for company can be deeply unappealing, and some men find the whole experience difficult. If you live near the clinic it may be possible to produce a sample at home and bring it in to the laboratory. If you do get the go-ahead to do this, you must get the sample back as quickly as you can, ideally within a couple of hours, and you shouldn't let it get too cold.
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| Treating Male Infertility |
It is usually recommended that you don't have intercourse for a few days before giving a sperm sample, which leads some men to assume they will have a much higher sperm count if they abstain from sex for longer than this. In fact, although abstaining for weeks may produce a higher volume of seminal fluid, there is often a decreased percentage of live, active sperm, so this isn't advisable.
The sperm test involves a number of checks to make sore the sample is normal and full of healthy sperm. The volume of fluid is checked, and it is examined to see how quickly it liquefies, which normally happens fairly soon after it has been ejaculated. The sample is examined under a microscope to see how many sperm are present (the sperm concentration) and to make sure the sperm are swimming fast enough and going forwards rather than moving erratically or just twitching about (this is known as the motility).
The sperm should not be stuck together (agglutination) as this can suggest there are antisperm antibodies present. The shape of the sperm (sperm morphology) will also be observed, as they sometimes have abnormally shaped heads or tails. The number of white blood cells may be checked, as high levels can indicate infection. Sometimes a sperm antibody test is also carried out, which checks for antibodies that can affect the way the sperm function and prevent them fertilizing an egg.
Sperm counts can vary considerably, and a normally fertile man may produce a sample with a low count at certain times, so it is worth repeating the sperm test if the results do suggest there could be a problem. Sperm production is a slow process, which takes about three months, and illness, medication or excess alcohol consumption during this period may affect the count.
Chlamydia screening
Chlamydia, a sexually transmitted disease, can cause fertility problems if it is not diagnosed. Chlamydia testing is simple and usually just involves taking a urine sample or a swab. If the results are positive, you and your partner will be prescribed a course of antibiotics. As chlamydia has no symptoms it can affect your fertility without your knowledge and if it has already caused damage to your fallopian tubes, the antibiotics will not be able to reverse this.
Ultrasound scans
A relatively unobtrusive way of looking at the ovaries, ultrasound scans can show how follicles are developing and whether there are any cysts that could suggest polycystic ovaries. An ultrasound scan can also give a view of the womb itself, and it is possible to check the lining to make sure it seems to be about the right thickness for the stage of the menstrual cycle.
Unlike pregnancy scans where the ultrasound probe is used externally on the stomach, most of the scans carried out during infertility investigations are done internally (known as transvaginal ultrasound scans), as this gives a clearer view of your reproductive organs. The scan works by using sound waves that send out echoes as they bounce off your body and these are used to give a picture.
At first, a transvaginal scan may feel rather odd and undignified, but they are painless and quite straight forward.
You will need to take off the clothes you are wearing on the bottom half of your body, and lie on a bed. The doctor then inserts the ultrasound probe into your vagina, and can look at your ovaries and follicles on a small screen.
'I had one of those internal ultrasound scans, and they detected polycystic ovaries straight away. I've had several scans now, and they're absolutely fine. I found the first one really informative as well, because they showed me exactly what was wrong. They pointed out the cysts on my ovaries, so I actually found it very helpful for me to understand" Lucy, 27. To find out more, you can check out Treating Male Infertility.
