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Male infertility investigations  

The first test in the evaluation of the infertile male is the semen analysis. This test is inexpensive, easy to perform and gives valuable information. A perfectly normal semen analysis report generally indicates a healthy man. Often, in the case of male infertility, the semen analysis is abnormal .
STANDARD SEMEN ANALYSIS TEST
Almost all laboratories will conduct tests and report on the following information, using values established by the World Health Organization :

  • Concentration (sometimes referred to as the count):  Average sperm concentration is more than 60 million per milliliter (>60 million/cc). Counts of less than 20 million per milliliter (<20 million/cc) are considered sub-fertile.
  • Motility (sometimes referred to as mobility): This describes the percentage of sperm that are moving.  Fifty percent or more of the sperm should be moving.
  • Morphology: This describes the shape of the sperm.  Thirty percent of the sperm should be normal by WHO criteria .
  • Volume: This is a measurement of the volume of the ejaculate. Normal is two milliliters (two ccs ) or greater. 
  • Total Motile Count: This is the number of moving sperm in the entire ejaculate. It is calculated by multiplying the volume (cc) by the concentration (million sperm / cc) by the motility (percent moving). There should be more than 40 million motile sperm in the ejaculate.
  • Standard Semen Fluid Tests: Color, viscosity (how thick the semen is) and the time until the specimen liquefies should also be measured. Abnormalities in the seminal fluid may adversely affect the sperm.

ABNORMAL SPERM ANAYSIS :
Oligospermia  ( low count)
Azoospermia ( no  sperms  seen in the sample)
Asthenospermia (decreased sperm motility)
Necrospermia (dead and immotile sperms)
Abnormality can be a combination of anyone.
 Additional investigations may be necessary to find the cause are semen culture, anti-sperm antibody estimation, scrotal ultrasound, hormonal assays, karyotyping , vasography .