Other than the inability to conceive within a stated period of time or the inability to deliver a live-born infant, in most cases, infertility has no other outward symptoms.
The evaluation of a man's fertility includes looking for signs of hormone deficiency, such as increased body fat, decreased muscle mass, and decreased facial and body hair. The evaluation also includes questions about the man's health history, including past injury to the testicles or penis, recent high fevers, and childhood diseases such as mumps.1 A physical examination allows for the identification of problems such as infection, hernia, or varicocele. A health care provider may also ask a man to provide a semen sample to assess the health and quality of his sperm. Other tests may include measurement of hormones in the blood, a biopsy of the testicle, or genetic screening.2
Treatments for male infertility may be based on the underlying cause of the problem, or in the case of no identified problem, evidence-based treatments that improve fertility may be recommended. Treatments include surgery to correct or repair anatomic abnormalities or damage to reproductive organs, use of medical procedures to deliver sperm to the woman, fertilization of the egg in a laboratory, and using a third party for donating sperm or eggs and/or carrying a pregnancy. Medication can treat some issues that affect male fertility, including hormone imbalances and erectile dysfunction. Surgery can be effective for repairing blockages in the tubes that transport sperm. Surgery can also be used for repair of varicocele.2 Assistive reproductive technologies, such as in vitro fertilization, can be effective if other treatments do not restore fertility.