In short
- When a couple cannot conceive, a male factor is present in a large share of cases.
- The man’s assessment is simple and is done at the same time as the woman’s.
- It relies on semen analysis, an examination, an ultrasound and a blood test.
- Some causes can be treated, such as a varicocele or a hormone imbalance.
When to get checked
After a year of regular sex without contraception, or sooner if the woman is over 35, if the man has a history (undescended testicle, infection, surgery, cancer treatment) or in case of sexual problems.
Semen analysis
This is the basic test. It looks at the number, movement and shape of sperm. It is done at the laboratory after two to seven days of abstinence. An abnormal result is often repeated, as values vary from one test to the next.
Other tests
Depending on the result, the andrologist completes the assessment:
- Examination of the testicles and check for a varicocele
- Testicular ultrasound
- Hormone tests (testosterone, pituitary hormones)
- In some cases, genetic tests
Solutions
Treatment depends on the cause: correcting a varicocele, treating an infection or a hormone imbalance, lifestyle advice. When natural conception remains difficult, the andrologist refers the couple to an assisted reproduction centre.
Lifestyle matters
Some habits improve semen quality:
- Stop smoking and cut down on alcohol
- Aim for a healthy weight and stay active
- Avoid excessive heat on the testicles (sauna, laptop on the lap)
- Never take testosterone or anabolic steroids without advice: they shut down sperm production
Frequently asked questions
Can semen quality improve?
Often, yes. Sperm renew in about three months: the effect of lifestyle changes and treatment shows on a new semen analysis a few months later.
Should both partners be seen together?
Ideally, both partners are assessed in parallel, to save time and not miss a cause.
Learn more
- CareMale fertilityWhen pregnancy takes a while, a male factor is involved in a large share of cases.
- CareVaricoceleA varicocele is an enlargement of the veins around the testicle, like varicose veins.
- CareLow testosteroneTiredness, low libido, erection problems: low testosterone may be the cause.
- CareUrological ultrasoundUltrasound uses sound waves to look at the kidneys, bladder, prostate and testicles.
More advice
Circumcision: reasons, procedure and recoveryPhimosis, infections, personal or religious reasons: why and how circumcision is done in children and adults, and how to care for it afterwards.Read the article
Low testosterone: symptoms, diagnosis and treatmentFatigue, low libido, erection problems: when to suspect low testosterone, how to confirm it and when treatment helps.Read the article
When should you see a urologist? The signs not to ignoreBlood in the urine, weak stream, pain, repeated infections, erection problems: the signs that should lead you to see a urologist in Brussels.Read the articleThis information is general and does not replace a consultation. In an emergency, call 112.
Article published by Dr Ayhan Bakar, urologist in Brussels (INAMI 17718534450).
Reference: European Association of Urology (EAU) guidelines.