Investigations of Male Infertility – howMed

Both partners should be evaluated for infertility. For investigation of male infertility, following should be done:

Clinical history regarding:

•    Systemic illnesses •    Thyroid disease •    Mumps •    Medications

•    Drugs

Physical examination:

•    Eunuchoid appearance •    Anosmia •    Gynecomastia •    External genitalia •    Testicular size

•    Visual field examination

Laboratory evaluation

Semen analysis: Semen analysis measures •    Ejaculate volume •    pH •    Sperm count •    Motility

•    Forward progression

Normal Values for Semen Analysis

PARAMETER                                                                    VALUE •    Ejaculate volume                                                      •    2-5 ml •    Sperm density                                                           •    >20million/ml •    Total sperm count                                                    •    60million/ml/ejaculate

•    Motility                                                                       •    >50% with forward progression

or >25% with rapid progression with 60min of ejaculation •    Morphology                                                               •    >30% normal •    pH                                                                                •    7.2-8.0 •    colour                                                                          •    Grey-white-yellow •    Liquefaction                                                               •    Within 40 mins

•    Fructose concentration                                            •    120-450 mg/ dL

2.    Endocrine parameters: •    Serum testosterone •    Serum FSH •    Serum LH

•    Serum Prolactin

3.    Antisperm antibody test  
4.    Testicular biopsy: To find histopathological abnormalities in testicular tissue
5.    Vasography : to see any obstruction
6.    Karyotyping: To visually determine chromosomal abnormalities