Approximately 15% of couples attempting their first pregnancy are unsuccessful. Patients can be diagnosed as infertile if they are unable to achieve a pregnancy after one year of unprotected intercourse. Approximately 30% of patients with fertility problems are male factor alone, another 20% of patients have both male and female factors combined. So, approximately 50% of infertile couples face male factor issues.

Advances in male infertility offer a wide range of successful treatment options to help couples conceive. Depending on the severity of the male factor, simple treatments such as sperm washing for inseminations may be recommended. In more severe cases, advanced treatments such as IVF with or without ICSI (intracytoplasmic sperm injection) may be a better option. IVF with or without ICSI may be used to overcome a male factor when less intensive therapy has been unsuccessful. ICSI is the procedure where a single sperm is inserted into the egg to complete fertilization.

The semen analysis is the first step in evaluating male infertility. This test provides important information about the quality and quantity of the sperm. The semen sample is analyzed for volume, viscosity (thickness), sperm concentration, motility, Krueger's morphology, and forward progression of the sperm. The sample is also examined for the presence of white cells and bacteria which may indicate infection. From this simple test, we can tell how many sperm are present, how many appear normal and how many are moving.

The semen sample can be collected at home in a sterile container after a 2-3 day abstinence period from ejaculation. The specimen should be brought to the office within 1 hour of ejaculation and it should be kept at body temperature during transport. This can easily be done by placing the container in a pocket next to your body. No lubrication should be used while obtaining the sample as it can be toxic to sperm.

Semen Concentration is the number of sperm in the specimen, measured in millions/milliliter. The normal range is greater than 20 million/milliliter.

Sperm motility is usually rated in two ways: the number of motile sperm as a percentage of the total, and the quality of forward progressive sperm movement.

Morphology is assessed on stained seminal smears after viewing at least 100 cells. When scoring Krueger's morphology, we are looking for normal forms, meaning an oval shaped head, with normal acromsome and properly attached tail.