One of the rarest but most serious causes of male factor infertility is germ cell aplasia.
The condition is characterized by the inability to produce sperm, resulting in azoospermic semen. The cause of germ-cell aplasia is not known; however, some researchers believe the condition develops from hormonal therapy, irradiation, gonadotropin deficiencies, environmental toxins, and other factors. Fertility is impossible for most patients with germ-cell aplasia and donor sperm is usually recommended to help couples conceive.
Other tests that may be helpful in diagnosing infertility include
- Blood work to check hormone levels of follicle stimulating hormone (FSH) and testosterone, also luteinizing hormone (LH), estradiol, or prolactin
- Tests to check for the presence of infection including HIV, hepatitis, Gonorrhea and Chlamydia all of which can impair fertility.
- Specialized semen analysis, including genetic testing of the sperm and evaluation for the presence antisperm antibodies
- Post-ejaculatory urine sample to rule out or indicate retrograde ejaculation.
- Cervical mucus penetration test a post-coital test is designed to evaluate the effect of a woman’s cervical mucus on a man’s sperm.
- Genetic testing may be recommended to couples with severely low sperm counts who will be using intracytoplasmic sperm injection (ICSI). Genetic testing can help identify the possibility of inheritable genetic diseases that can be passed on to children.