- Opening Hours
- Timing: Mon to Sat - 10 AM to 5 PM
- Address: Positron Hospital, Health Center Plot Block B Suncity, Sector 35, Suncity Township-I, Rohtak, Haryana 124001
- Call Us+123-456-78-09
- Opening Hours
- Timing: Mon to Sat - 10 AM to 6 PM
- Address: Positron Hospital, Health Center Plot Block B Suncity, Sector 35, Suncity Township-I, Rohtak, Haryana 124001
Male Infertility Evaluation
Male infertility contributes to approximately half of all cases of couple infertility. It is defined as the inability to achieve pregnancy after 12 months of regular unprotected intercourse. Evaluation is recommended earlier if there are known risk factors (e.g., history of testicular surgery, chemotherapy, varicocele, or hormonal issues). A systematic approach helps identify treatable causes and guides appropriate management.
Here are illustrations of the male reproductive system showing key structures involved in fertility:
Initial Assessment and History Taking
Evaluation begins with a detailed medical and sexual history and physical examination.
Key points covered in history:
- Duration of trying to conceive
- Previous pregnancies (with current or previous partner)
- Frequency and timing of intercourse
- History of undescended testes, mumps, sexually transmitted infections, surgeries (hernia, varicocele, vasectomy)
- Exposure to heat (saunas, hot tubs), toxins, radiation, or anabolic steroids
- Medications, smoking, alcohol, recreational drugs
- Erectile dysfunction or ejaculation problems
Physical examination focuses on:
- Secondary sexual characteristics
- Testicular size and consistency (normal ≈ 15–25 mL per testis)
- Presence of varicocele (often detected standing and with Valsalva maneuver)
- Signs of hormonal imbalance (e.g., gynecomastia, reduced body hair)
Laboratory and Diagnostic Tests
Semen analysis is the cornerstone of evaluation and should be performed after 2–5 days of abstinence.
Standard parameters checked:
- Volume
- Sperm concentration
- Total sperm count
- Motility (progressive and total)
- Morphology (normal forms)
- Vitality and presence of white blood cells
At least two semen analyses (preferably 1–3 weeks apart) are recommended.
Additional tests based on initial findings:
- Hormonal profile (FSH, LH, testosterone, prolactin)
- Genetic testing (karyotype, Y-chromosome microdeletion) in cases of severe oligozoospermia or azoospermia
- Scrotal ultrasound to assess testes, epididymis, and varicocele
- Post-ejaculatory urinalysis (to detect retrograde ejaculation)
Next Steps After Evaluation
Results guide further management:
- Obstructive azoospermia → surgical exploration or sperm retrieval
- Varicocele → consider varicocele repair in selected cases
- Hormonal abnormalities → medical treatment (e.g., gonadotropins, clomiphene)
- Genetic issues → genetic counseling
- Unexplained infertility → assisted reproductive techniques (IUI, IVF/ICSI)
Early and thorough evaluation by a urologist specializing in andrology or reproductive medicine is essential. Many causes are treatable, and timely intervention improves the chances of achieving pregnancy naturally or with assistance.