What should I expect at the first visit to the doctor? You should anticipate a thorough history and physical examination. It may be beneficial to have both partners present at this first visit to facilitate data gathering by the physician. This will also allow your partner to have her questions adequately answered in person.

What testing is usually ordered? Testing will often be initiated at the time of the first visit, and this generally includes measurement of blood hormone levels (FSH, LH, testosterone, and prolactin) to ensure an intact HPG axis. Additionally, you should ask ahead of time if you would be expected to collect a semen sample for semen analysis at that visit. It is usually recommended that men observe two to three days of abstinence prior to undergoing a semen analysis. Most doctors will allow collection of the semen sample at your home, as long as it arrives in the laboratory within one hour. Other specialized semen testing may be ordered as well, and the patient's clinical history as well as the availability of the specific tests usually determine which tests will be obtained.

I am concerned about my job. How much time should I expect to miss if I have one of the surgical procedures described above? The majority of the procedures discussed in this booklet can be performed on an outpatient basis. The timing of return to work is variable, depending on the nature of the patient's work duties. Generally, even with the more invasive procedures described above, patients are able to return to work within several days. There may be some activity restrictions for a few weeks, and these should of course be discussed on an individual basis with your physician.

I feel healthy and take care of myself. Could I have done something differently to prevent this from happening? Most patients with male factor fertility problems are, overall, quite healthy. Although some individuals do develop problems after "preventable events" (exposure to environmental toxins, radiation, trauma, etc.), most causes of male infertility are likely present from birth and thus unavoidable. Unavoidable does not mean untreatable and under the care of a properly trained physician, the chances of a successful pregnancy with subsequent childbirth are optimized.