Retrograde EjaculationRetrograde ejaculation occurs when the muscles of the urethra do not pump properly during orgasm and sperm are forced backward into the bladder instead of forwarding out of the urethra. This condition is a common consequence of bladder neck or prostate surgery and may also be caused by diabetes, multiple sclerosis, and spinal cord injury. It can also be a temporary side effect of certain drugs such as tranquilizers or hypertension medication.
Tests used to Diagnose Male Infertility
Physical ExamA urologist will usually perform a physical examination to detect any abnormalities, such as a varicocele in the testes and prostate problems. Checking the size of the testicles is also helpful. Smaller–sized and softer testicles along with tests that show low sperm count are strongly associated with essential problems in sperm production, a low–sperm count in men whose testicles have normal size and consistency indicate possible obstruction. The temperature of the scrotum can be determined with a test called scrotal thermography. The physician may also take a urine sample to detect sperm in the urine (indicating retrograde ejaculation).
Semen AnalysisThe basic test to evaluate a man’s fertility is a semen analysis. To perform this test, a man collects a sample of his semen in a collection jar during masturbation either at home or at the physician’s office. For those for whom religion or culture prohibits masturbation, a silicon semen collection device (stockiest–Rocket) may be available that will enable collection of a sample during sexual intercourse. A man should abstain from ejaculation for several days before the test, because each ejaculation can reduce the number of sperm by as much as a third. (The maximum number of sperm is usually obtained by abstaining for about four days.)
Proper collection procedure is important, since the highest concentration of sperm is contained in the initial portion of the ejaculate. The sample should be kept at body temperature and delivered promptly, because if the sperm are not analyzed within two hours or kept reasonably warm, a large proportion may die or lose motility. A semen analysis should be repeated at least three times over several months. Both the man and the woman should be present when the physician discusses the result of this analysis so that both partners will understand the implications. The analysis should report any abnormalities in sperm count, motility, and morphology as well as any problem in the semen.