When to Test His Fertility

Clomiphene citrate (Clomid, Serophene): Clomiphene citrate is an orally administered medication often used in women because it leads to an increased production of follicle stimulating hormone (FSH) by the pituitary, stimulating the ovaries. The rationale behind the use of clomiphene in men is that it will also result in increased levels of FSH, stimulating the testicles to produce more sperm. There is no good evidence that the use of clomiphene in men results in improved sperm production or better pregnancy rates.

Human menopausal gonadotropins: These medications are actually preparations of the hormones FSH and luteinizing hormone (LH) (Pergonal, Humegon), or FSH alone (Metrodin, Fertinex, Gonal-F, Follistim). They must be administered by injections, usually daily, and they are very expensive. In the rare individual whose pituitary does not produce LH and FSH, these preparations can be quite effective. In individuals whose pituitary gland functions normally but the sperm count is decreased, the value of these medications is much more questionable.

Human chorionic gonadotropin (hCG): Although this was a popular form of therapy in the past, it has not been found to be of value and is rarely used anymore.

Vitamins: There have been reports touting everything from vitamin E to vitamin C to zinc as the cure for decreased sperm production. I would suggest that everyone take some nice multivitamin, not megadoses, and leave it at that.

The evaluation and management of the male all stems from the semen analysis. Knowing which decisions follow certain results allows a couple to understand the steps involved and follow along with the evaluation.

Semen Analysis
If the semen analysis is abnormal, it should be repeated. Before repeating it, eliminate any of the possible causes of abnormal evaluations as listed above. Also be sure to repeat it after an adequate period of time has elapsed to allow improvement to occur. Remember, it takes 70 days to produce a mature sperm.