Hi!
Your husband could have a (expensive) blood test to check for
KlinefeltersKlinefelter syndrome. It would be very useful information for you two to have though, in terms of your chances of conception and your children's risk of genetic variations.
I have done "cheater" semen analysis for patients before by doing a post coital test.
This is an old test, and not used very much any more, but could be an in-expensive starting point for you two. The couple is asked to have
intercourseCauses of painful intercourse
Sexual intercourse - painful within 12 hours of the office visit and at the woman's mid-cycle (around day 13 or 14). The cervical mucous is then obtained (like a pap smear) and evaluated. We can look under the microscope and see how many motile sperm are present in the mucous.
If you were my patient, this is how I would start out. If I saw very few or no sperm, I would be even more inclined to do a karyotype on your husband. If he truly does have Klinefelter's you may need to consider IVF with ICSI (intra-cytoplasmic sperm injection).
If there were jillions of happy sperm, I would then encourage the two of you to get a "real" semen analysis. The wife can help with masturbation, or the husband can withdraw to produce the specimen if either of these suggestions helps!
I hope this information is useful ( and not more graphic than you wanted!)
Good luck!
Dr B