Clinical examination and Lab tests in a presumed case of male subferility

 

)  A  tall, robust man with scanty , scanty  beard, less  mustache - may be  a case of Klinefelter’s Syndrome.

B) Age above> 50 yrs  may be a cause of  poor sperm quality

C) Gynaecomastia; Eunuchoid appearance, less body hairs, absence of male pattern body hairs, Small testis will spak of hypogonadism

D) Search  for local causes: . Any hydrocele, hernia, epididymitis, any scar in scrotum/ inguinal region,  Per rectum palpable seminal vesicles and or enlarged prostate.

 

Q.12 :  What Investigations of male partner?

 A) Hepatitis serology, B) Viral Screen c) TSH, Free T4, d) PRL  c)  BMI  ,d) to measure  BP, e)  If earlier repot suggest suboptimum then one should repeat preferably after 2 months i.e. Routine semen analysis,    f) . Hormones like FSH, LH and Testosterone, g) Tests for systemic diseases,   h) . Sperm function tests, i) . Chromosomes,   j) .Aspiration of testicular materials should not be done except by andrologist at ART centre with facilities of cryopreservation of sperms., and h) Gene testing if advised by Andrologists otherwise not , i) Vasography is not done nowadays but scrotal sonography and imaging of seminal vesicles and Prostate should be done as such are noninvasive procedure ..

 

 

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