Following a history and physical examination, the initial evaluation of the male partner involves at least one properly performed semen analysis. Ideally, semen should be collected by masturbation, after 2 to 3 days of abstinence, into a clean container provided by the facility and examined within an hour after collection. A 2nd sample is usually recommended in the event of an abnormal initial semen analysis. A comprehensive analysis includes an evaluation of sperm count, overall motility and proportion of normal sperm (morphology) present in the sample. The objective is to get a sense of the semen quality and determine the need for additional testing including hormonal or genetic testing or referral to a specialist in male reproduction/urologist.
Although controversial, a variety of specialized tests and procedures are available to measure sperm function and level of DNA damage in the sperm that may adversely affect fertility.
Unless a specific treatable condition is identified in the male, there are no medical treatments that can improve fertility in men with unexplained infertility. Some nutritional supplements have been associated with improved semen parameters but have not been shown to improve pregnancy outcomes.