Patient's question:
Detailed medical history and consultation purpose: Hello, I would like to ask, we have been married for a year and still haven't had a child. I have had a gynecological examination before. The examination results showed that it was simply irregular menstruation. Now, my periods come basically on time every 35 days, but I don't know if this is considered regular. We have used ovulation tests, and there are soft signs of ovulation, and we have also taken basal body temperature, which also shows ovulation, but we have not become pregnant yet. Please ask, should we do a male examination? Our home is opposite to Xuhui District No. 6 Hospital. I would like to ask, which hospital is better to go to for examination, and which doctor is 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. General checks include height, weight, and the distance between the tips of the outstretched hands; observe the development of secondary sexual characteristics, such as facial hair, Adam's apple, axillary hair, and pubic hair growth, 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 (softness/hardness) of the testicles. Check for thickening, tenderness, and cysts of the epididymis. Examine the vas deferens and varicocele. If necessary, a rectal examination may be performed to assess the size and consistency of the prostate, and massage may be done to obtain prostatic fluid for laboratory testing.The most important and simple laboratory test is semen quality analysis. The results of semen analysis act like a mirror, reflecting many causes of infertility. If the test results show abnormalities in sperm count, motility, and 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 issues with testicular sperm production 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 ascent test, post-coital test, and hamster egg penetration test with zona pellucida removal. Testing for the presence of antisperm antibodies in semen and blood requires sperm agglutination tests and sperm immobilization tests. In recent years, the Nanjing Xiaoguan Infertility Diagnosis and Treatment Center has collaborated with the Maleology Laboratory of the Department of Histology at Nanjing Medical University to further develop high-tech enzyme-linked immunosorbent assays (ELISA) for detecting antisperm antibodies, substrate membrane methods for measuring sperm acrosome enzyme activity, and more.