Medical History and Physical Examination

• Medical History:
• Age
• General health status
• History of medical conditions (e.g., diabetes, hypertension, mumps orchitis)
• History of surgeries (e.g., inguinal hernia repair, testicular surgery)
• History of infections (e.g., sexually transmitted infections, urinary tract infections)
• History of drug use (e.g., recreational drugs, certain medications)
• Lifestyle factors (e.g., smoking, alcohol consumption, occupational exposures)
• Sexual history (e.g., frequency of intercourse, libido, ejaculatory function)
• Family history of infertility
• Physical Examination:
• General physical examination
• Focused examination of the genital tract:
• Inspection of the penis and scrotum for abnormalities
• Palpation of the testicles for size, consistency, and presence of varicocele
• Assessment of secondary sexual characteristics

Laboratory Tests

• Semen Analysis:
• Volume
• Sperm concentration
• Sperm motility
• Sperm morphology
• pH
• Liquefaction time
• Presence of leukocytes and other cells
• Hormonal Evaluation:
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Testosterone
• Estradiol
• Prolactin
• Thyroid-stimulating hormone (TSH)
• Genetic Testing:
• Karyotype analysis (to detect chromosomal abnormalities)
• Y chromosome microdeletion analysis (to identify specific genetic defects)
• Other genetic tests as indicated by clinical findings
• Other Tests:
• Postcoital test (to assess sperm-cervical mucus interaction)
• Sperm function tests (e.g., sperm-zona pellucida binding assay, sperm penetration assay)
• Ultrasound of the scrotum (to assess testicular size, blood flow, and varicocele)
• Scrotal biopsy (to evaluate testicular tissue)

When to Consult a Fertility Consultant

You should consult a fertility consultant if you experience any of the following:

• Difficulty achieving pregnancy after one year of unprotected intercourse (or six months if you are over 35 years old)
• History of infertility or previous unsuccessful pregnancies
• History of sexual dysfunction or pain during intercourse
• Abnormal semen analysis results
• Known medical conditions that affect fertility
• Family history of infertility