Diagnosis of Male infertility
Diagnostic Test list for Male infertility:
The list of medical tests
mentioned in various sources as
used in the diagnosis of Male infertility
includes:
Male infertility Diagnosis: Book Excerpts
Diagnostic Tests for Male infertility: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Male infertility.
INFERTILITY, MALE:
Ask the Following Questions:
(Algorithmic Diagnosis of Symptoms and Signs)
- 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.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
INFERTILITY, FEMALE:
Ask the Following Questions:
(Algorithmic Diagnosis of Symptoms and Signs)
- Are there abnormalities on pelvic examination? Abnormalities found on the pelvic examination are cervicitis, stenosis of the cervix, fibroids, retroverted uterus, tubo-ovarian abscesses, and polycystic ovaries.
- Are there abnormal secondary sex characteristics? Patients with Turner's syndrome, Simmonds' disease, Fröhlich's syndrome, and virilism may exhibit abnormal secondary sex characteristics.
- Are there other abnormalities in endocrine examination? The physical examination may disclose hypothyroidism, hyperthyroidism, Simmonds' disease, or acromegaly.
DIAGNOSTIC WORKUP
Routine studies include a CBC, urinalysis, urine culture and colony count, chemistry panel, thyroid profile, VDRL test, and a vaginal smear and culture. Cervicitis should be biopsied and treated. The next logical step is to obtain a specimen of semen from the husband for sperm count.
If the above tests are negative, referral to a gynecologist is in order. If one is not available, further workup can be done, including a serum FSH and LH, serum estradiol, and serum progesterone to determine the presence of pituitary or ovarian causes of ovulatory dysfunction. A hysterosalpingogram can be done. The patient can keep a temperature chart to determine if ovulation occurs. Cervical mucus studies can be done for spinnbarkheit testing and
ferning
, and the presence of significant white cells should be noted. Pelvic ultrasound may be done, and laparoscopy may be necessary to rule out other conditions that may affect fertility. A trial of clomiphene citrate may be given. Endometrial biopsy may also contribute to solving the diagnostic dilemma.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
INFERTILITY:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The workup of infertility first involves doing a sperm count on the male. If that is normal and the examination of the female discloses no gross abnormality, a temperature chart is kept by the patient or the Spim–Barkeit test is used to determine if the female ovulates. Thyroid function studies and serum/prolactin, FSH, LH, estradiol, and progesterone levels may all be done if ovulation is proved not to take place. Other tests such as tubal insufflation, hysterosalpingogram, and a trial of clomiphene will be useful in selected cases. Establishing the time of ovulation and ensuring copulation at that time often solves the problem. Cauterizing a chronic cervicitis may lead to fertility. Counseling about emotional problems may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Male infertility:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
A detailed patient history may reveal abnormal sexual development, delayed puberty, infertility in previous relationships, and a medical history of prolonged fever, mumps, impaired nutritional status, previous surgery, or trauma to genitalia. After a thorough patient history and physical examination, the most conclusive test for male infertility is semen analysis. The specimen is collected after 2 to 3 days of complete abstinence to determine volume and viscosity as well as sperm count, motility, swimming speed, and shape.
Other laboratory tests include gonadotropin assay to determine the integrity of the pituitary gonadal axis, serum testosterone levels to determine end organ response to luteinizing hormone (LH), urine 17-ketosteroid levels to measure testicular function, and testicular biopsy to help clarify unexplained oligospermia and azoospermia. Vasography and seminal vesiculography may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Female infertility:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Inability to achieve pregnancy after having regular intercourse without contraception for at least 1 year suggests infertility. (In women older than age 35, many clinicians use 6 months rather than 1 year as a cutoff point.)
Diagnosis requires a complete physical examination and health history, including specific questions on the patient’s reproductive and sexual function, past diseases, mental state, previous surgery, types of contraception used in the past, and family history. Irregular, painless menses may indicate anovulation. A history of PID may suggest fallopian tube blockage. Sometimes PID is silent, and no history may be known.
The following tests assess ovulation:
❑ Basal body temperature graph shows a sustained elevation in body temperature postovulation until just before the onset of menses, indicating the approximate time of ovulation.
❑ Endometrial biopsy, done on or about day 26, provides histologic evidence that ovulation has occurred. However, endometrial biopsy is retrospective, which diminishes its utility.
❑ Progesterone blood levels, measured when they should be highest, can show a luteal phase deficiency or presumptive evidence of ovulation.
The following procedures assess structural integrity of the fallopian tubes, the ovaries, and the uterus:
❑ Urinary LH kits, available without a prescription, can sensitively detect the LH surge about 24 hours preovulation, allowing couples to time coitus.
❑ Hysterosalpingography provides radiologic evidence of tubal obstruction and uterine cavity abnormalities by injecting radiopaque contrast fluid through the cervix.
Male-female interaction studies include the following:
❑ Postcoital test (Sims’-Huhner test) examines the cervical mucus for motile sperm cells following intercourse that takes place at midcycle (as close to ovulation as possible).
❑ Immunologic or antibody testing detects spermicidal antibodies in the female’s sera.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Infertility:
Differential Overview
(Field Guide to Bedside Diagnosis)
Female Factors
❑ Anovulation
❑ Tubal obstruction
❑ Endometriosis
❑ Polycystic ovary disease
❑ Luteal phase dysfunction
❑ Cervical factors
❑ Uterine leiomyoma
❑ Testicular feminization
Male Factors
❑ Genitourinary infection
❑ Erectile dysfunction
❑ Drugs
❑ Retrograde ejaculation
❑ Varicocele
❑ Germinal compartment failure
❑ Partial androgen resistance
❑ Hypogonadotrophic hypogonadism
❑ Primary hypogonadism
Diagnostic Approach
Couples should be encouraged to attempt to conceive (unprotected intercourse) for 1 year before undergoing evaluation. Ovulation usually occurs if there have been spontaneous, regular, cyclic menses, but this can be confirmed by daily measurement of basal body temperature. The sperm count and motility can be ascertained to be adequate only by semen analysis. Male factors account for about 25% of infertility.
Interpersonal issues such as career stress, differences in desire for children (a clue is that one partner only seeks evaluation), or unacknowledged homosexual preference may interfere with effective coitus.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Infertility, male:
Diagnosis
(Handbook of Diseases)
A detailed patient history may reveal abnormal sexual development, delayed puberty, infertility in previous relationships, and a medical history of prolonged fever, mumps, impaired nutritional status, previous surgery, or trauma to the genitalia.
After a thorough patient history and physical examination, the most conclusive test for male infertility is semen analysis. Other laboratory tests include gonadotropin assay to determine the integrity of the pituitary gonadal axis, serum testosterone levels to determine organ response to luteinizing hormone (LH), urine 17-ketosteroid levels to measure testicular function, and a testicular biopsy to help clarify unexplained oligospermia and azoospermia. Vasography and seminal vesiculography may be necessary.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Infertility, female:
Diagnosis
(Handbook of Diseases)
Diagnosis requires a complete physical examination and health history, including specific questions on the patient’s reproductive and sexual function, past diseases, mental state, previous surgery, types of contraception used in the past, and family history. Irregular, painless menses may indicate anovulation. A history of PID may suggest fallopian tube blockage.
Clinical tip Infertility is a disorder of couples, so both partners should be evaluated.
Tests that assess ovulation
❑ Basal body temperature graph shows a sustained elevation in body temperature after ovulation until just before onset of menses, indicating the approximate time of ovulation. Oral temperatures are taken every morning before rising. This method isn’t as diagnostically useful as other methods.
❑ Endometrial biopsy, done on or about day 5 after the basal body temperature rises, provides histologic evidence that ovulation has occurred.
❑ Progesterone blood levels, measured when they should be highest, can show a luteal phase deficiency. Over-the-counter ovulation predictor kits are less expensive and quite accurate.
Procedures that assess structural integrity
❑ Hysterosalpingography provides radiologic evidence of tubal obstruction and abnormalities of the uterine cavity by injecting radiopaque contrast fluid through the cervix.
❑ Endoscopy confirms the results of hysterosalpingography and visualizes the endometrial cavity by hysteroscopy or explores the posterior surface of the uterus, fallopian tubes, and ovaries by culdoscopy. Laparoscopy allows visualization of the abdominal and pelvic areas.
Male-female interaction studies
❑ Postcoital test (Sims-Huhner test) examines the cervical mucus for motile sperm cells after intercourse that takes place at midcycle (as close to ovulation as possible).
❑ Immunologic or antibody testing detects spermicidal antibodies in the sera of the female. Further research is being conducted in this area.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
INFERTILITY:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The workup of infertility first involves doing a sperm count on the
man. If that is normal and the examination of the woman discloses no gross
abnormality, a temperature chart is kept by the patient or the Spinnbarkeit
test is used to determine if ovulation occurs. Thyroid function studies and
serum/prolactin, FSH, LH, estradiol, and progesterone levels may all be
measured if ovulation is proved not to take place. Other tests such as tubal
insufflation, hysterosalpingogram, and a trial of clomiphene will be useful
in selected cases. Establishing the time of ovulation and ensuring
copulation at that time often solve the problem. Cauterizing a chronic
cervicitis may lead to fertility. Counseling about emotional problems may be
necessary.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
In rare cases of male infertility, a man may be unable to produce or ejaculate any sperm at all. Though this state of affairs may seem bleak, many...
Affecting over three million American women, difficulty becoming pregnant after having a child can come as a surprise. This so-called secondary...
Germs are a fact of life and catching an infectious disease like a cold may seem inevitable. But there are simple ways to protect yourself against...
Stress takes its toll by making us anxious, depressed and not able to function as fully as we'd like. What many don't know is that stress can...
See full list of 4 related videos
» Next page: Signs of Male infertility
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
