The first test in the evaluation of the infertile male is the semen analysis which is also known as sperm count. The sperm count is inexpensive, easy to perform and gives valuable information.
A perfectly normal semen analysis report generally precludes a significant male factor component and investigation and treatment should be more appropriately targeted at the woman. In fact, in many countries, the first test in the evaluation of an infertile couple is the semen analysis. This is generally performed before any other tests are conducted on the woman.
Often, in the case of male infertility, the semen analysis is abnormal:
Either the count is low (oligospermia) or sperm are altogether absent in the ejaculate (azoospermia), or sperm motility (movement) is seriously affected (asthenospermia), or sometimes the sperm are totally immobile or dead (necrospermia).
There are many other anomalies that one may find on semen analysis. When a problem is found, the next step is to try and find a cause for it. To do this, one usually performs additional investigations. Some of the other tests that may need to be performed are a semen culture, anti-sperm antibody estimation, scrotal ultrasound, hormonal assays, karyotyping, vasography, etc.