History of a male parner in an infertile
couple
Duration of
infertility.
1. Erectile and
ejaculatory function along with coital frequency and timing are important.
Awareness about the ovulation time, can significantly affect fertility
outcomes.
2. Surgery for
hernia, or other surgery which may affect ejaculation, like orchidopexy, hernia
repair, testicular torsion, testicular trauma, retroperitoneal lymph node
dissection for testicular tumours and bladder neck surgery should be noted.
3. Neurological
and psychological conditions could also affect the ability to ejaculate.
Infections like mumps related orchids and smallpox are associated with impaired
spermatogenesis. Any infection or febrile illness is also associated with
abnormal semen analysis, for up to 6 months.
4. Delayed
onset of puberty and gynecomastia may be associated with endocrine and
chromosomal abnormalities and should be asked for.
1. Detailed
general examination, to identify development of secondary sexual
characteristics, is important.
2. Genetic and hormonal
causes may be identified by physical features unique to them.
3. Examination
of the genitalia
• Assessing
the size and the consistency of the testes, including measurement using an
orchidometer, gives an idea about possible atrophy, indicating that the
seminiferous tubules are inadequate.
• Palpation of
the epididymis and the vas deferens helps in establishing any obstruction to
the passage of sperms from the testes
• Examination
of the spermatic cords will identify the presence and grade of varicocoele.
4. Digital
rectal examination
• It
identifies any cystic dilatation of the seminal vesicles and ejaculatory ducts
• Tenderness
in this area helps to identify prostatic infections.
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