Patient's question:
What are the general tests required for a gynecological examination to determine a woman's fertility? How should a man seek medical attention? Does frequent withdrawal during intercourse affect him? When he experiences ejaculation during intercourse, does it leave some residue in the woman's body, which could cause pregnancy? Looking forward to your reply! Thank you!Doctor's answer:
Hello, the main examination items for male infertility are mainly divided into the following six aspects:1. Routine Semen Analysis
This is the most basic and important clinical indicator for assessing male fertility. The parameters of semen are the first information physicians need to understand. Patients should note the following:
- Abstain from intercourse for 3–5 days before the test.
- Preferably collect the sample through masturbation.
- Ensure all semen is collected.
- Recheck 1–2 times within 2 weeks.
2. Semen Biochemical Analysis
Analyzing the chemical composition of seminal fluid helps assess the function of the epididymis, prostate, and seminal vesicles. Semen biochemical analysis is recommended for patients with conditions such as low semen volume, azoospermia, oligospermia, unexplained or idiopathic sperm motility disorders, congenital defects or diseases of accessory glands, and other related issues. Common parameters include fructose, carnitine, and acid phosphatase.
3. Microbiological Testing Related to Male Infertility
Infections of the male urinary and reproductive systems often lead to male infertility. Pathogenic microorganisms associated with these infections include bacteria, viruses, spirochetes, mycoplasma, chlamydia, etc. Common pathogens include Neisseria gonorrhoeae, human papillomavirus, adenovirus, and Chlamydia trachomatis.
4. Endocrine Testing Related to Male Infertility
Reproductive endocrine dysfunction affects male sexual and reproductive functions and is a significant factor or cause of male infertility. Endocrine testing primarily involves measuring sex hormones (T, FSH, LH, PRL, E2) and various stimulation tests, such as the HCG stimulation test.
5. Genetic Testing Related to Male Infertility
The normality of male-related chromosomes and genes is the foundation for maintaining normal reproductive function. Abnormalities in chromosomes and genes can lead to abnormal sexual differentiation and/or impaired sperm production, severely affecting reproductive function. Therefore, chromosomal and genetic testing is of great importance for individuals with gender differentiation abnormalities, other genetic defects, azoospermia or severe oligospermia, or those with a family history of genetic diseases, as well as for couples experiencing habitual miscarriages.
6. Prostatic Fluid Examination
Prostatitis can cause male infertility. Prostatic fluid examination provides evidence for the diagnosis of prostatitis.
(Dr. Deng Zhaohui, Deputy Chief Physician of the Reproductive Center, Hunan Maternal and Child Health Hospital)
For female examination items:
1. Basal Body Temperature (BBT) Measurement
Measure the temperature under the tongue for 5 minutes in a resting state every morning, and record it in a specially designed chart. On a monthly cycle, normal women exhibit a biphasic BBT pattern under the influence of ovarian function. This helps determine ovulation dates, the presence or absence of ovulation, and ovulation dysfunction.
2. Sex Hormone Testing
Measurements include serum LH, FSH, PRL, E2, P, T, T3, and T4. This test is particularly useful in diagnosing unexplained or idiopathic infertility in women.
3. Cervical Mucus Examination
Assesses ovulation and corpus luteum function.
4. Endometrial Pathology Examination
Determines ovulation status or corpus luteum function and also evaluates uterine cavity size and abnormalities, such as tuberculosis or fibroids.
5. Hysterosalpingography (HSG) or Tubal Patency Test
Methods include hysterosalpingography with iodinated oil, tubal fluid infusion, and tubal patency tests to assess whether the fallopian tubes are open.
6. Post-Coital Test and Sperm Penetration Test
Evaluates sperm motility.
7. Immunological Testing
Detects antisperm antibodies (AsAb) in the blood. Antibodies may cause sperm agglutination or loss of motility, leading to infertility.
8. Chromosome Testing
If a man frequently practices withdrawal during intercourse, it generally has no significant impact. However, during intercourse, if he experiences this ejaculation tendency, a small amount may remain in the female body, but it is unlikely to cause pregnancy.