The male partner will require to provide one or more sperm counts with 3 days abstinence. The sample should be produced into a clean container by masturbation (not into a condom) and taken to the lab without becoming too hot or cold (i.e. maintained at body temperature) within 1 hour of production. The parameters should be a volume of at least 2 mils, 20 million sperm per mill. 50% motile (swimming) and at least 30% normal in formation. There should be no evidence of infection and no anti sperm antibodies (chemicals produced by the body to react against the sperm). If the initial count is suboptimal then this should be repeated, and as all men have variable counts it should not be cause for undue concern.
If repeated tests show abnormalities then life style changes such as stopping smoking, reducing alcohol consumption, not wearing tight underclothes, and vitamin supplementation in the form of individual tablets high dose vitamin C, E, Zinc, Selenium and L Carnitine (an amino acid – protein precursor ) can often help. If not a testicular examination to exclude a varicocele (varicose vein of the testicle, commoner on the left) and hormone blood test (FSH, LH, thyroid function, Prolactin and Testosterone) can be helpful. If the parameters are consistently abnormal then consideration should be given to a Chromosome analysis (check of the body’s genetic code) by a blood test. This will show problems that not only can be a cause but can be passed on to a future generation, e.g. Cystic Fibrosis (carried by 1 in 25 of the Anglo Saxon population) or micro deletion of the Y chromosome which provides the maleness required to be a man, and if defective will be a cause of abnormal sperm count which would be inherited by his son. If the man is found to be a carrier of a condition then his partner should also be tested to make sure that they will not have a chance of having a child with the full medical illness e.g. cystic fibrosis.
If the problem is persistent and severe then treatment will involve a test tube baby technique (IVF see later and ICSI) where an individual sperm is injected into an egg.