For a man it is relatively easy. Doctors usually begin by testing his semen and look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man's hormones if there is suspicion there may be an imbalance or problem.
- Sperm Chromatin Structure Analysis (SCSA): During the SCSA test, sperm are treated with a chemical to allow entry of a special dye into the sperm cell. The dye sneaks its way into crevices in the DNA molecule. In theory, sperm with fragmented DNA take up more of the dye. Then, using a procedure called flow cytometry, the sperm that took up lots of dye can be differentiated from the sperm that took up only a little dye. Finally, each sperm can be graphed out or the percentage of sperm with fragmented DNA can be determined.
- Vericocele: In many cases, men are examined for varicocele, which is a mass of dilated veins that develops within the scrotal sac. Varicocele can increase the temperature in the testes and affect sperm factors, such as sperm count. Varicocelectomy, a surgical procedure treats varicocele. About 50% of men who undergo varicocelectomy to correct infertility father children within the first year. It often takes about 6 months for a sufficient quantity of new sperm to be produced to permit fertilization. Semen analysis usually is done at three- and six-month intervals after the operation. Varicocele is a condition that affects approximately 40 percent of infertile males.
- Cryptorchidism: This can seriously impair fertility rates. If the testes do not properly descend into the scrotom this is called cryptorchidsm. This is fairly common in premature births. Usually it will resolve itself within a few weeks, but if it doesn’t, corrective surgery is needed. If both testes are affected, the chance of a successful pregnancy is very small without the surgery.
