Male Fertility Evaluation

The semen analysis is crucial to the evaluation of male fertility issues. RBA recommends that men have at least three semen analyses over the course of two weeks, following a history and physical exam. Multiple semen analyses are necessary due to a high amount of variability in samples such that a single analysis may not be fully representative of the individual’s fertility. At least two days of abstinence are needed prior to each analysis and specimens need to arrive at the laboratory no later than one hour after collection.

Your medical team will take a thorough medical and familial history during your fertility evaluation, including:

• Age
• Fertility history, including the number of previous partners and pregnancies
• Previous fertility work-up
• If applicable, female fertility work-up
• Sexual history
• Childhood history, including the onset of puberty, childhood diseases, injuries, and surgeries
• Medical history, including diseases such as diabetes and hypertension
• Adult surgical history, including hernia repair and bladder surgery
• History of infections (e.g., prostatitis, epididymitis, and venereal diseases)
• Exposure to toxic substances, including pesticides and chemicals
• Social history, including smoking, alcohol, and recreational drug use
• Family history, including paternal history of infertility, recurrent miscarriage, and chromosomal abnormalities

Your medical team will also perform a thorough physical exam, including:

• Thyroid
• Cardiac
• Abdomen
• Penis, Scrotum, and Testicles – It is important to examine the patient in the standing position, having him perform the Valsalva maneuver (i.e. take a deep breath and bear down) in order to evaluate the presence of varicoceles. Physical structures such as testicular size, uniformity, and the presence of vas deferens will be evaluated.

Additional testing may be required to verify physical findings. These tests may include:

• Ultrasound examination of the prostate, testicles, spermatic cord, and kidneys
• Hormone blood tests for FSH, LH, testosterone, and prolactin levels
• Antibody testing of the semen
• Sperm function testing
• Testicular biopsy