Consider DNA tests for men with infertility. (Get Test Done Before Referral).

MONTREAL -- Gynecologists who discover male factor infertility in the course of a couple's fertility work-up should perform a few key tests in the man before referring the couple for further treatment, speakers said at the 11th World Congress on Human Reproduction.

"A certain percentage of men who have sperm counts below 5 million may have either DNA damage or chromosomal anomalies, which should be diagnosed early on, because they may indicate that the patient should bypass certain treatments," said Dr. David Page, professor of biology at the Massachusetts Institute of Technology, Cambridge.

"There are certain regions of the Y chromosome where, if there is a deletion, you are not going to find any sperm even with testicular biopsy So by doing this test early on, you help the patient avoid unnecessary treatments, costs, and the associated risks," he said in an interview.

Of men with sperm counts below 5 million, 10%-15% have a DNA deletion on their Y chromosome (the AZFC deletion) which, if they conceive a child, has a 100% rate of transmission to their male offspring.

"You would expect these babies to be perfectly healthy except for this inherited infertility. I think that for many couples and clinicians it is simply useful to have this information," he said.

Another 10%-15% of men with oligospermia or azoospermia have other chromosomal anomalies that also have implications for treatment.

"I suspect there are a lot of varicocele repairs that are done that make no sense if a man has a chromosome abnormality, and the same goes with male hormonal treatments," he added.