Laboratory tests include:
1 Urinalysis to detect the presence of infections.
2 Semen analysis to evaluate the motility (movement), shape (morphology), and maturity of the sperm, the volume and liquidity of ejaculation, and the actual sperm count. The sperm counts mostly fluctuate from one analysis to the other. Therefore, multiple semen evaluations are done over a period to get accurate results.
3 Hormonal tests to evaluate the levels of testosterone and follicle stimulating hormone (FSH) to understand the overall hormonal balance and state of sperm production. Sometimes, the initial hormonal testing indicates the need for other hormonal tests such as serum luteinizing hormone and prolactin.
4 If the above diagnostic tests are unable to determine the condition, further testing is done to identify the cause of infertility.
5 Scrotal ultrasound uses high-frequency sound waves to detect obstructions or problems in the testicles and other supporting structures.
6 Transrectal ultrasound is done by inserting a tiny and lubricated wand into the rectum to check the prostate and tubal blockages (ejaculatory ducts and seminal vesicles) that they might carry.
7 Post-ejaculation urinalysis helps detect the sperm in the urine indicating retrograde ejaculation, where the sperm travels backward into the bladder.
8 Seminal fructose test checks if seminal vesicles are producing fructose in the semen. The fructose sugar provides energy to the sperm.
9 Semen leukocyte analysis checks for white blood cells in the semen.
10 Anti-sperm antibodies test looks for the presence of antibodies that could cause infertility.
11 Sperm penetration assay (SPA) identifies the ability of the sperm to fertilize.
12 Kruger and the World Health Organization (WHO) morphology detects the sperm morphology and motility closely.
13 Testicular biopsy checks for the impairment or a blockage in sperm production.
14 Vasography detects the structure of the ducts and finds obstructions.
15 Genetic testing identifies mutations in gene regions of Y chromosome and diagnoses various inherited or congenital syndromes.
The treatment depends on the cause of infertility.
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