Diagnosing male factors of infertility.

Abstract

The male factor is responsible for failure to conceive in approximately 50% of infertile couples. We considered the most appropriate plan for the evaluation of the male in this review. A comprehensive evaluation includes determination of the couple's history of infertility, their sexual habits, the husband's developmental, medical, and surgical histories, family history, exposure to gonadotoxins, and a thorough review of systems. Laboratory tests include endocrine evaluation, semen analysis, quantitation of leukocytes in semen, and antisperm antibodies. Tests of sperm function can include evaluation of cervical mucus interaction, ova penetration, and the hemizona assay. Additional tests may include transrectal ultrasonography, venography, and testis biopsy.