Male fertility examinations are an important part of evaluating a couple’s fertility and investigating infertility. They help identify possible causes of infertility and provide the basis for a treatment plan.
Typically, testing always begins with a standard semen analysis, but other methods can be used when needed.
A semen analysis (or sperm analysis) is usually the first and most essential examination in evaluating male fertility. A fresh semen sample is analyzed to determine key factors affecting the sperm’s ability to fertilize an egg. The analysis assesses factors, including semen volume, sperm count, motility, and possible sperm antibodies.
If all values fall within reference ranges, additional testing is usually not necessary.If abnormalities are found, further tests may be needed to clarify the situation. Typically, an abnormal result is first verified with a repeat analysis. If the result is only slightly reduced, lifestyle changes and/or lighter treatments such as intrauterine insemination (IUI) may be considered.
A physical examination provides valuable information about the testes and surrounding structures. It is also important to assess the man’s general health.
A significant varicocele, or dilated veins in the scrotum, can be detected clinically. Mild varicoceles are common and usually do not require treatment. A significant varicocele, however, may impair sperm production and fertility, and the potential benefit of treatment should be evaluated individually.
If semen quality is particularly poor or if a significant change has been observed, an ultrasound examination of the testes may be necessary. The aim is to rule out testicular tumors. Calcifications, or testicular microlithiasis, found in some individuals may also require follow-up or further testing. An ultrasound examination is a quick and painless procedure that can be performed during a regular appointment.
Hormone testing (typically testosterone, FSH, LH, prolactin, and thyroid function tests) determines whether hormone levels are balanced. Adequate testosterone production in the testes is essential for normal sperm production. Hormone measurements are also used to determine whether the issue lies in the testicular function itself or in its regulatory mechanisms. Based on this, it is possible to evaluate whether hormone therapy could help improve semen quality and male fertility.
If semen quality is severely reduced, it is essential to investigate potential genetic causes. These include:
This evaluatyion analyzes the integrity of the genetic material in the sperm. High sperm DNA fragmentation can negatively affect fertilization, embryo development and pregnancy success.
Based on the results, we will consider how DNA fragmentation can be reduced, in some cases it is enough to choose the most suitable methods for selecting sperm for ICSI fertilization in the laboratory.
Male fertility evaluation overall consist of semen analysis in abnormal cases, clinical examination, ultrasound, measurement of hormone levels and, if necessary, genetic studies. The studies provide a comprehensive picture of fertility and guide the preparation of a treatment plan to maximize the chance of pregnancy.
