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Diagnosis and care for male

Diag­no­sis begins with a semen assess­ment and often hor­mone test­ing (includ­ing FSH, LH, testos­terone and pro­lactin). Other diag­nos­tic steps include but are not lim­ited to:

  • Ultra­sound: of the prostate and sem­i­nal glands
  • Semen assess­ment: a front line test to eval­u­ate the main para­me­ters of con­cen­tra­tion (sperm num­bers), motil­ity and mor­phol­ogy (sperm shape) from an ejaculate.
    • Nor­mo­zoosper­mia:
      Nor­mal ejac­u­late as defined by WHO ref­er­ence values
    • Oligo­zoosper­mia:
      Sperm con­cen­tra­tion less than WHO ref­er­ence values
    • Astheno­zoosper­mia:
      Sperm motil­ity less than WHO ref­er­ence values
    • Ter­a­to­zoosper­mia:
      Sperm mor­phol­ogy less than WHO ref­er­ence values
    • Oligoas­thenoter­a­to­zoosper­mia (OAT):
      Dis­tur­bance of all three vari­ables (com­bi­na­tions of only two pre­fixes may also be used)
    • Azoosper­mia:
      Com­plete absence of sperm within the ejaculate
    • Asper­mia:
      No ejac­u­late
    • Cryp­to­zoosper­mia:
      Few sper­ma­to­zoa recov­ered after centrifugation
  • Bio­chem­i­cal and urine analysis
  • Immuno­log­i­cal test­ing, includ­ing detec­tion of anti­sperm antibodies.
  • Tests on the inter­ac­tion of sperm and cer­vi­cal mucus, includ­ing for exam­ple the post­coital test accord­ing to Sims-Huhner, or the SCMC (sperm cer­vi­cal mucus con­tact) con­tact test.
  • Tes­tic­u­lar biopsy
  • Func­tion tests in erec­tile dysfunction
  • Micro­surgery TESEMESA
  • Micro­surgery for men includes MESA/TESE
    (micro­sur­gi­cal epi­didy­mal sperm aspi­ra­tion / tes­tic­u­lar sperm extrac­tion). Both pro­ce­dures are per­formed under gen­eral anaes­thetic and are used to obtain sperm, which is then processed for ICSI.
    MESA is used effec­tively for obstruc­tive azoosper­mia and usu­ally yields high sperm counts for IVF, with the goal of obtain­ing enough sperm for sub­se­quent IVF cycles.
    TESE is used for sperm extrac­tion and is an open biopsy pro­ce­dure. It is often used when no sperm are found in the epi­didymis; how­ever, it yields fewer sperm than MESA.