When should Hormonal Testing be done?
Hormone levels should be measured if:
- Sexual functioning of the male partner is not satisfactory (erectile dysfunction, low libido)
- An earlier diagnose has yielded disorder related to Thyroid hormone.
- Sperm concentration is less than 10 x 106sperm/mL
Testicular biopsy is a surgical procedure that helps the doctors in doing a first-hand analysis of the testicular tissue of the male partner, under a microscope.
How is the procedure executed?
First, antiseptic medicine is applied evenly on the skin that covers the testicle. A sterile towel covers the area around the testicle. Then, a local anesthetic is given to the patient to numb the area.
Then the doctor proceeds towards the surgery. A small surgical incision is made through the skin, and a small piece of the testicular tissue is extracted. The opening in the testicle is then stitched shut. After that, the incision made in the skin is also sealed via stitching. If need be, the procedure might be executed on the second testicle too.
Another method of tissue extraction, that does not need a surgical cut, is Needle biopsy. The starting steps are same as an open biopsy. That is, sterilizing of the area and application of local anesthesia is done. After that, a special needle is used to extract a sample of the testicle. This process does not require any cut in the skin.
Imaging – Scrotal Ultrasound
In the cases where the doctor feels that a detailed analysis of testicles is needed, a testicular ultrasound is used. It is an imaging method used to observe and diagnose defects in the testicles. Following are the cases that might motivate your doctor to recommend a testicular/scrotal ultrasound :
- Check whether the testicle has a solid/firm lump. A presence of such a lump indicates the presence of a cyst, a tumor or a fluid-filled-sac.
- If the scrotum area has suffered some physical injury or trauma, this procedure can be used to measure the level of damage sustained by the scrotum.
- Check whether the male partner has a twisted testicle (also called testicular torsion).
- If the male partner is suffering from pain or swelling of testicles, this procedure can be done to identify the causes.
- Detect for and evaluate varicoceles, which are varicose spermatic veins.
- Assess the other causes of infertility.
- If the patient has an undescended testicle, this procedure can help the doctor in locating it.
A scrotal ultrasound can reveal structural or blockage issues in the testicles. To check problems related to the vesicles that transport semen or the ejaculatory ducts, a transrectal ultrasound may be used.
This process involves the analysis of the post-ejaculatory urine for the presence of sperm in the male’s urine. If the sperm is present, this might indicate a retrograde ejaculation (also called dry ejaculation).
Advanced Tests for Male Infertility Testing:
- Blockage of the vas deferens
The epididymis is a twenty-foot-long, tightly coiled duct inside the scrotum that collects sperms from the seminiferous tubules. These tubules are where the manufacturing of sperms takes place. This duct is present in the back of the testis and as the walls of this duct start to thicken and straighten up, it becomes the vas deferens. When the sperms are passing through the epididymis, they mature and gain movement. If there is a blockage in the epididymis, it might prevent the sperm from entering the vas deferens. This blockage can occur either on one side or both the sides. This blockage can be a result of a hydrocele repair or a hernia. If the obstruction is on one side, the patient may have a comparatively lowered sperm count. If the obstructions persist on both sides, this might result in a zero sperm count (also called azoospermia).
Retrograde ejaculation (sometimes called “dry ejaculation”)
Occurs when the semen, that is ejaculated via the urethra, is released back into the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation and consequently forcing the semen to exit via the urethra. If there are any issues with the functioning of the bladder sphincter, then failure may occur in contraction and lead to retrograde ejaculation.
Erectile dysfunction is the case associated with the ability of the penis in staying erect. If you are not able to have a stable erection while having sex or you can see a loss in your libido (interest in sexual activities) or you have a trouble in getting an erection, then you might be suffering from erectile dysfunction.
The study indicates that up to 10 % of couples, who are experiencing infertility or repeated loss in pregnancy, have problems stemming from their genetics. Genetic Testing can play an important role in diagnosing and treating such cases.