The general procedure for diagnosing male infertility: First, determine whether the issue lies with male infertility, female infertility, or both partners. If male infertility is suspected, clarify whether it is absolute or relative infertility, and whether it is primary or secondary. Finally, identify the underlying cause of male infertility.
Diagnostic methods for male infertility typically include detailed medical history review, physical examination, laboratory tests, imaging studies, and other assessments.
First, the physician will conduct a thorough medical history interview, which is crucial for establishing diagnostic hypotheses. Inquiries generally cover marital and reproductive history, sexual history, past medical history, and family medical history.Second, physical examination includes assessing height, weight, body shape, and degree of obesity. This helps differentiate male infertility conditions such as congenital testicular abnormalities, trauma, and hypoplasia. A prostate massage may also be performed to collect prostatic fluid for laboratory analysis. Next comes laboratory testing to rule out bacterial infections like epididymitis, vesiculitis, urogenital tract inflammation, and prostatitis.Additionally, semen analysis is a crucial diagnostic tool for male infertility, reflecting sperm quality produced by the testes, patency of the sperm ducts, and secretory function of the epididymis. Reminder: Self-examination can detect warning signs Causes of male infertility primarily include genetics, hormonal abnormalities, varicocele, reproductive tract infections, cryptorchidism, unhealthy lifestyle habits, and environmental pollution.Men can conduct effective self-examination by learning basic fertility knowledge and self-assessment methods.
If you gently palpate along the spermatic cord from top to bottom and detect large, worm-like, soft, and tortuous masses within the scrotum, be vigilant—this may indicate varicocele.This condition elevates testicular temperature, and venous blood stasis disrupts testicular metabolism, thereby interfering with spermatogenesis and reducing semen quality. If testicular swelling and pain occur, followed by gradual testicular shrinkage after relief, it may indicate testicular torsion or post-inflammatory atrophic testicular damage.This often involves irreversible damage to sperm-producing cells. If the testicle fails to descend into the scrotum and remains in the abdominal cavity, it is called cryptorchidism. The elevated temperature in the abdominal cavity is unfavorable for sperm production and significantly increases the risk of testicular malignancy.
Observing semen can also partially indicate fertility. Normal semen appears grayish-white or slightly yellowish. Pink or red semen indicates hematospermia. Normal semen volume ranges from 2 to 6 milliliters; volumes exceeding 7 milliliters are considered excessive. This not only lowers sperm density but also increases the likelihood of semen leakage from the female body, reducing the total sperm count.A volume below 2 milliliters indicates low semen volume, while less than 1 milliliter is considered extremely low and highly likely to cause infertility. Typically, semen liquefies within 15-30 minutes after ejaculation. If it fails to change consistency after 30 minutes, this clinical condition is called semen non-liquefaction, another cause of infertility.