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