When Should We See a Doctor?
Infertile couples are now encouraged to proceed with a fertility evaluation when they first suspect a problem with their reproductive function. The workup for the male patient generally should be undertaken at the same time as that for the female.
What Is Involved in the Evaluation of the Male Patient?
A thorough history will review the general health of the patient, duration of the infertility problem, sexual habits, previous pregnancies and earlier treatment as well as the history of illnesses such as postpubertal mumps and testicular torsion.
The physical examination will focus on the penis and scrotal contents, testicular size and consistency, presence or absence of the vas deferens and swelling or tenderness of the epididymides. The physician will examine for the presence of enlarged veins around the testicle (varicoceles) and conduct a prostate examination.
Routine laboratory testing
Laboratory testing will include semen analysis and determination of serum hormone levels of specific hormones including FSH, LH, testosterone and prolactin. Abnormalities may be a sign of a primary hormone problem in the hypothalamus, pituitary, or testis.
Serum Hormome Levels
A routine part of the initial evaluation is a determination of blood levels of specific hormones usually including FSH, LH, testosterone, and prolactin levels. The interrelationship of these four hormones is closely tied to normal sperm production. Abnormalities may be a sign of a primary hormone problem in the hypothalamus, pituitary, or testis