INFERTILITY, MALE
INFERTILITY, MALE: Excerpt from Algorithmic Diagnosis of Symptoms and Signs
Ask the Following Questions:
- Are there abnormalities on examination of the external genitalia and prostate? Abnormalities that need to be looked for are Klinefelter's syndrome, epididymitis, testicular atrophy, urethritis, and prostatitis.
- Are there abnormalities on the endocrine examination? The general endocrine examination may reveal hypothyroidism, hyperthyroidism, or hypopituitarism.
- Are there stress factors that need to be considered such as marital difficulties or overwork? Overwork and marital difficulties may lead to drug addiction and alcoholism, among other problems. All these affect fertility.
DIAGNOSTIC WORKUP
Routine laboratory tests include a CBC, urinalysis, chemistry panel, thyroid profile, VDRL test, and sperm count. If there is a urethral discharge, a smear and culture should be done. If the sperm count reveals oligospermia on two separate specimens, referral should be made to a urologist or endocrinologist for further evaluation.
Additional tests that can be ordered include blood tests for LH, FSH, and testosterone. Additional tests of pituitary function may be indicated. Karyotype testing and sperm function tests may be needed. If these are normal, a testicular biopsy may need to be done. Ultrasonography of the testicles may be helpful.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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