Investigations of Male Infertility

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