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Infertility

HOW MALE INFERTILITY IS DIAGNOSED

Male infertility issues are more common than what many people imagine. Whenever a couple is having difficulties in having a baby, more often than not, the problem is assumed to be with the woman. In reality, male infertility problems are responsible for about 40% of couples who want but cannot have a baby.

History

To arrive at a diagnosis of male infertility, history is important. Here, the doctor will be looking for anything in the past that could contribute to fertility problems in the male. These include:

  • Problems with sperm production due to infections, testicular injuries and torsion; use of radiation and testicular varicosity. Some of these can also cause blockage of sperms.
  • Sexual history. How often does the couple engage in unprotected sex? Any ejaculation problems such as premature ejaculation or ejaculate backflow into the bladder? Also the following are considered.
    • Erection difficulties
    • Ejaculation failure
    • Widely spaced intercourse
    • Spinal injury
    • Use of certain drugs

Examination

A fertility specialist or urologist usually carries out the physical examination. These include a detailed examination of the male genitalia that will involve the scrotum, the vas deferens, testes, the penis and the pattern of the pubic hair. Another area that will be given attention is the prostate.

Laboratory investigations

These include:

  • Urinalysis to rule out infections or confirm retrograde ejaculation
  • Semen analysis. This checks the size and shape of the sperms; the volume, motility and the amount (number of sperms in a given volume)
  • Blood tests will include hormonal tests – testosterone, pituitary hormone levels.
  • Serological tests for chlamydia, HIV and hepatitis

Radiological investigations

The area of focus is the testis. An ultra-sound can help to identify tumors, varicocele, abnormal testis and problems with the vas deferens.

Genetic testing

Testing of the chromosomes may be indicated where no obvious problem has been identified from the history examination or the above tests. This may help to identify any chromosomal disorders that may be inherited by any baby that could come later.

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