Patient's question:
Detailed medical history and consultation purpose: Hello, I would like to ask, we have been married for a year and have not had any children yet. I have previously undergone a gynecological examination. The results showed that it was simply irregular menstruation. Now, my periods come regularly every 35 days. I don't know if this is considered regular. We have used ovulation tests, and there were soft signs of ovulation, and we have also taken basal body temperature, which showed ovulation as well. However, we have not become pregnant yet. I would like to ask, should we have a male examination? Our home is opposite to Xuhui District Sixth People's Hospital. Could you please advise which hospital would be better to go to for the examination and which doctor would be the best to see? Thank you!Age
Current general condition: Haven't gone to the doctor yet
Doctor's answer:
Hello: Infertile men should undergo a physical examination, which generally includes measurements of height, weight, and the distance between the tips of the outstretched hands. The development of secondary sexual characteristics should also be observed, such as the growth of facial hair, Adam's apple, axillary hair, and pubic hair, as well as the presence of gynecomastia. The focus of the examination is the urinary and reproductive systems. This includes assessing the size of the penis, the presence of hypospadias, the size and consistency of the testicles, and checking for thickening, tenderness, or cysts in the epididymis. The vas deferens and varicocele should also be examined. If necessary, a rectal examination may be performed to assess the size and consistency of the prostate, and prostatic fluid may be expressed for laboratory testing.The most important and simplest laboratory test is semen quality analysis. The results of this test serve as a mirror, reflecting many causes of infertility. If the test results show abnormalities in sperm count, motility, or the number of abnormal sperm, it indicates abnormal semen quality, and the test should be repeated 2–3 times. If the results remain abnormal, it suggests that there may be a problem with testicular spermatogenesis or accessory glands. Biochemical tests of semen, such as fructose, acid phosphatase, zinc, and carnitine, can reflect the function of the seminal vesicles, prostate, and epididymis, respectively. Other methods for assessing sperm quality include the sperm climb test, post-coital test, and hamster egg penetration test with zona pellucida. Testing for the presence of antisperm antibodies in semen and blood requires sperm agglutination tests and sperm immobilization tests. In recent years, the Nanjing Xiguan Infertility Diagnosis and Treatment Center has collaborated with the Maleology Laboratory of the Department of Histology at Nanjing Medical University to further develop high-technology-level enzyme-linked immunosorbent assays (ELISAs) for detecting antisperm antibodies, substrate membrane methods for measuring sperm acrosomal enzyme activity, and more.