Physical Examination and Medical History
This is a mandatory procedure for evaluating a man’s fertility. Physicians will complete a medical history chart by asking several questions about time of infertility, lifestyle choices, previous illness, inherited conditions and surgeries.
Physical examination of genitals is also performed to exclude presence of problems that affect testes and supporting structures.
Sperm analysis is the main test performed to evaluate fertility of a man. The test evaluates certain characteristics of semen and parameters of sperm function which are concentration of spermatozoa, overall motility and morphological characteristics.
Antisperm antibody test
The presence of antibodies in semen is examined by evaluating the percentage of spermatozoa affected by these proteins. The test uses sperm sample and special substances that attach to affected spermatozoa. This test can also be used to examine the presence of antibodies in woman’s body.
This is also an important part of infertility investigation in both men and women. The doctor will advise testing for the level of hormones that regulate male reproductive system. These include testosterone and follicle stimulating hormone (FSH). If indicated the doctor will also check for other hormones such as Lutenizing hormone (LH), estradiol and prolactin.
Genetic testing is performed only if the above tests cannot explain the problem of fertility. In this case investigation may include chromosome analysis, Y-chromosome micro-deletions, and sperm DNA fragmentation test.
In case of no spermatozoa present in semen the doctor will suggest testicular biopsy to test the presence of spermatozoa in testicles. The procedure is also performed to retrieve sperm for use in IVF.