Male infertility Diagnostics

About infertility

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Even on condition of having regular unprotected intercourse, if a couple in which the female partner ages under 35 fails to conceive in 12 months (or after 6 months, if the woman is over 35) they are advised to undergo a detailed fertility screening to reveal causes that could be affecting their reproductive ability. Up to 50% of all episodes are related to male infertility factors.

The first step in the evaluation of male infertility is to obtain a thorough medical, reproductive and urological history. Then, to receive a thorough physical examination to evaluate the pelvic organs — the penis, testicles, prostate and scrotum. However, the cornerstone of the male infertility work-up is the semen analysis (to evaluate the sperm quantity and quality).

Additionally, other specific tests for male infertility diagnosis include:

  • Post-ejaculatory urine sample (a post-ejaculatory urinalysis should be performed in a case having an ejaculate volume < 1.0 ml- to exclude retrograde ejaculation. It’s important to rule out an improper or incomplete collection or a very short abstinence interval).
  • Blood tests to evaluate hormone levels (Testosterone (T), follicle stimulating hormone (FSH), lutenizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH), and sex hormone-binding globulin).
  • MAR test (Mixed Antiglobulin Reaction test is used to diagnose immunological infertility)
  • Genetic tests to identify chromosomal defects (Y-chromosome microdeletions), genetic diseases (Klinefelter’s syndrome) or a number of other possible genetic mutations).
  • DNA fragmentation (the damage of the sperm DNA, either during creation or maturation. Such sperm DNA damages are also associated with spontaneous miscarriage).
  • Scrotal ultrasound (to identify most scrotal pathology: varicocle, spermatocele, absent vasa, epididymal induration and testicular masses).
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