Diagnostic Procedures for Males

Diagnostic Procedures for Males

In order to assess infertility in men, the following can be conducted: semen analysis, semen culture, hormonal analysis, urological exams, PESA, TESA or TESE, viral tests, and genetic investigations.

Semen Analysis

During semen analysis, four properties of a single ejaculate are measured. The characteristics recorded are the volume of the ejaculate, the concentration of the sperm (count), the percentage of the sperm that are moving (motility), and the percentage of the sperm that are normal in shape (morphology). Normally, the ejaculate of a man will be greater than 2cc in volume, will have a sperm count of approximately 20 million/cc, will have 50% motile sperm, and will have 15-20% morphologically normal sperm.

Semen Culture

This is mainly performed in cases of symptomatic diseases or when pus cells have been observed in semen analysis (leucospermia).

Percutaneous Epididymal Sperm Aspiration (PESA)

If a urological exam is conducted and reveals blockage or absence of the vas deferens, then PESA may be undertaken in order to obtain viable sperm. During PESA, the male is given local anesthesia, general anesthesia, or he may be sedated. Sperm is then aspirated from the epididymis, or the housing area for produced sperm.

Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE)

In TESA or TESE, the testicular tissue containing the semineferous tubules (the actual location of sperm production) is aspirated or extracted from the testes while the patient is under local or general anesthesia. This tissue can then be frozen in order to prevent the need to repeat this particular procedure.

This procedure is necessary in cases of azoospermia (absence of sperms) or severe oligoasthenospermia (diminished number/motility of sperms) in patients with at least one normal sized testis and normal FSH. It may provide prognostic information for the application of ICSI with testicular sperms.

Hepatitis (B & C), HIV

Tests are administered routinely to diagnose patients carrying these viruses, as they can be transmitted to the female or to attending healthcare providers.