Before we start the first investigations, i.e. the examination of the ejaculate, we discuss with you to obtain the first basic information about your health condition.

We obtain all this information with the aim of carrying out the most successful 

treatment possible.

2. Basic examination of a man

The basic examination of a man is an examination of the seminal ejaculate or spermiogram. We determine whether a sufficient amount of high-quality, motile and morphologically correct spermatozoa are produced.
Before the examination, we recommend a 2 to 7 – day sexual break for men.
The examination of the seminal fluid is carried out twice with an interval of 6 to 8 weeks. If the spermiogram is abnormal, we recommend a clinical examination of the genitals and an ultrasound examination of the testicles. We also recommend taking nutritional supplements that can affect sperm development.

3. A physical examination of the testes and penis 

It allows for identification of problems, such as: 

• infection, signaled by discharge or prostate swelling
• hernia
• malformed tubes that transport sperm
• hormone deficiency as indicated by small testicles or lack of facial and body hair
• presence of a mass in the testicles
• varicocele (abnormal veins in the scrotum)

4. Genetic testing in men

Genetic testing of a man is indicated in further cases:

• if there are no sperm in the ejaculate (azoospermia)
• if there are less than 1.000.000/ml sperms in the ejaculate 
• in the case of repeated spontaneous abortions 
• with the risk of hereditary defects.
  

Approximately 5-15 % of men with a severe defect in the number or quality of sperm also have abnormalities in their chromosomes, which can be diagnosed with a blood analysis – the so-called karyotype determination.

A microdeletion on the Y chromosome

10-20 % of men with severe sperm count disorders (below 1.000.000/ml) but with a normal number of chromosomes (karyotype) are carriers of a Y chromosome disorder. This type of disorder is called a microdeletion, and the Y chromosome does not contain very important genes that are responsible for the production and development of seminal fluid. Affected men can also pass the disorder onto their sons.

Cystic fibrosis and congenital atresia of the vas deferens (CAVD)

This disorder occurs only in men with a complete absence of sperm in the ejaculate. Men with CAVD often also carry a cystic fibrosis (CF) gene mutation. Therefore, genetic testing for cystic fibrosis is necessary in men with azoospermia.

5. Hormonal analysis of men

A male hormone analysis is performed in the event of a very abnormal spermiogram result. The values ​​of FSH, LH and testosterone, sometimes PRL are checked.

6. TESE testicular biopsy

Testicular sperm extraction (TESE) is a surgical procedure used to retrieve sperm from the seminiferous tubules of a male’s testes, performed under local anesthesia. It’s used for men with non-obstructive azoospermia, which is when a man cannot produce enough sperm to have a detectable amount in his semen — a common cause of male infertility.

See more about the procedure here.