The semen analysis is the cornerstone of the male infertility workup. A specimen is collected by masturbation in the vicinity of andrology lab into a clean, dry, sterile container or during coitus using special condoms (containing no spermicidal lubricants). The patient should be abstinent for 2-5 days prior to maximize sperm number and quality. The semen is sent to the laboratory to measure the number of sperm present, check for abnormalities of shape (morphology), and determine motility (movement) issues. Sperm counts can fluctuate from one specimen to the next, so the specialist will conduct several semen analysis tests over a specified timeframe. This is the best way to ensure accurate results.
Additional tests are used to identify the cause of the infertility if the semen analysis and initial examination is normal. These tests include:
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Scrotal ultrasound – Uses high-frequency sound waves to produce visual images inside the scrotum (testes). This is used to check for a varicocele and other problems of the testicles and support structures.
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Hormone testing – Hormones are produced by the hypothalamus, pituitary gland, and testicles. Abnormalities of blood hormone levels can contribute to infertility.
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Post-ejaculation urinalysis – Sperm in the urine indicates that sperm has traveled backward into the bladder instead of out the penis during ejaculation. This condition is known as retrograde ejaculation.
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Genetic tests – If sperm concentration is low or nil it could be related to a genetic cause. A blood test is used to detect subtle changes in the Y chromosome, inherited syndromes, and congenital problems.
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Testicular biopsy (PESA/TESA/TESE) – Involves removing samples from the testicle using a needle. This test checks for sperm production. Lack of sperm indicates a blockage or problem with sperm transport.
Transrectal ultrasound – To check the prostate gland, a small ultrasound probe is inserted into the rectum. Using sound-wave imaging, the doctor checks for blockages of the tubes that transport semen (seminal vesicles and ejaculatory ducts).
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Dr. Shweta Mittal Gupta, a doctor par excellence, a great orator, a wonderful human being and above all my inspiration, my mentor. May God bless her in all her endeavours.
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Dr. Shweta Mittal Gupta, a doctor par excellence, a great orator, a wonderful human being and above all my inspiration, my mentor. May God bless her in all her endeavours.
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