Despite a flourishing urban myth that the female partner is more frequently the cause of a couple’s infertility, the cause is actually equally distributed between men and women. Infertility is due a male factor alone in approximately 30% of infertile couples, while combined male and female factors comprise an additional 20%, therefore the male is involved in approximately 50% of infertile couples. Infertility is a common condition, and it is estimated that over 7 million couples seek infertility care annually in the United States each year, although the frequency of a dedicated male factor evaluation with a urologist is significantly less common. The accepted definition of infertility by the American Society for Reproductive Medicine (ASRM, link: www.asrm.org) is the inability to naturally conceive within 12 months.
A male fertility evaluation begins with an appointment with a urologist specialized in reproductive medicine. A complete medical and reproductive history will be taken, including previous medical problems, surgeries, medications, and occupational and lifestyle factors than could all contribute to fertility problems. A sexual history including any sexual symptoms will be obtained. A physical exam will be performed, and finally testing will be performed including hormone blood tests and a semen analysis. In certain cases, more advanced genetic testing or imaging may be required for a diagnosis. The majority of cases have an identifiable cause, although about 20% are characterized as “idiopathic,” meaning the cause cannot be identified. Treatments may include starting hormone therapy or other medication, or may even require surgery. The female partner should be evaluated as well so as to coordinate the fertility care.
Dr. Coward is the reproductive specialist at UNC Urology. He evaluates fertility patients at UNC Fertility in Raleigh, NC. Visit the website at UNC Fertility to learn more (link www.uncfertility.com), or to schedule an appointment call 919-908-0000.
This fertility history questionnaire should be filled out prior to the appointment. The patient may either bring a copy previously filled out at home, or it may be filled out in the waiting room prior to the visit. Click here for Fertility History Questionnaire.