Male Evaluation in New York
Fertility Screening Process for Men
Roughly half of the couples that deal with infertility issues usually do so because of a contributing male infertility factor. For this reason, reproductive specialists must perform a male evaluation to decipher what is causing his infertility, so that they can solve the issue to the best of their ability, administering the proper treatment that he needs. A male evaluation can consist of a medical history, physical examination, semen analysis, sperm morphology, hormone testing and other procedures.
Once the doctor goes over the male patient’s medical history – gaining a better understanding of any medical problems, prior surgeries, family history and drug, tobacco or alcohol use – the physical examination will take place. The patient’s blood pressure assessment, height, weight and body mass will all be recorded. Afterward, a physical examination can be performed to evaluate his testes, spermatic cords, and prostate.
Commonly referred to as the “sperm test”, a semen analysis isn’t a true measurement of fertility. However, it could suggest the likelihood of the male achieving fertility based on sperm motility and sperm concentration. Often if the first semen analysis is abnormal, it’s recommended to repeat a second one to confirm and help decide treatment. Sperm morphology – the evaluation of the shapes of sperm – is also performed. This helps doctors figure out whether or not the sperm can penetrate and fertilize eggs with in vitro fertilization (IVF).
Because there are abnormalities in pituitary-gonadal hormones that can cause infertility, a hormone test may be given to the male patient, providing important information on the state of sperm production. The hormones that are typically evaluated during this test include testosterone, thyroid, prolactin, LH, estradiol and FSH. A male’s hormone levels should definitely be evaluated and measured if his sperm concentration is less than 10 x 106 sperm/milliliters; he experiences diminished sexual function; or if exams reveal a specific hormonal disorder.
In the event that the medical history, physical examination, semen analysis and hormone tests do not produce some sort of findings regarding a man’s infertility, then further testing can be done. A seminal fructose and post ejaculate urinalysis can be performed to determine if the male has missing seminal vessels or retrograde ejaculation. Semen leukocyte analyses detect round, immature sperm and possible leukocytes that could be prohibiting male fertility.
Sperm DNA fragmentation assay can also be done to determine the structure of sperm chromatin, which makes up the sperm’s DNA, analyzing Fragmented DNA is found in 5% of infertile men who have a normal semen analysis, and 25% of infertile men with abnormal semen analyses. It’s important to note that causes of DNA fragmentation are usually reversible, and include tobacco use, air pollution, infection, chemotherapy, steroid use, certain medications, and more. Other tests can include Scrotal Doppler ultrasounds, transrectal ultrasounds, CT scans, a pelvic MRI, karyotyping and Y chromosome analyses.
Male Fertility Testing in New York
If you’re dealing with male infertility, please do not hesitate to contact the NYU Langone Reproductive Specialists of New York office for a male evaluation – you can easily request an appointment online. Our team of doctors, nurses and medical assistants specialize in fertility care, and have years of experience successfully helping male patients achieve fertility.