Patient's question:
My husband doesn't know if he has infertility. He wants to go to the hospital for an infertility check-up. I persuaded him for a long time before he could bring himself to do it. What are the items for male infertility tests? He doesn't want to get injections, he's afraid.Doctor's answer:
Male Infertility Examination ItemsMale infertility examination includes the following items:
1. Urinalysis
Introduction to Urinalysis: A urinalysis analyzer, also known as a dry chemical urinalysis analyzer, is simple and fast to operate (can complete the detection of 11 urine components within 10 seconds).
Normal Values for Urinalysis: pH 5–7; Specific Gravity (SG) 1.015–1.025; Protein (PRO) Negative; Glucose (GLU) Negative; Ketones (KET) Negative; Bilirubin (BIL) Negative; Nitrite (NIT) Negative; Leukocytes (LEU) Negative; Red Blood Cells (RBC) Negative; Vitamin C 20–100 mg/L.
2. Blood Count Examination
Blood count examination includes hemoglobin determination, red blood cell count, white blood cell count, and classification. The required materials include a microscope, micropipettes, hemocytometer, hemoglobin reagent, and various diluents and stains.
This is a micropipette, also known as a hemoglobin pipette. It has two scales, indicating 10 and 20 mm3, respectively. When taking blood, attach a rubber bulb and a three-way tube to facilitate manual fixation during operation.
This is the side vent hole. Squeezing the rubber bulb and blocking the hole creates negative pressure in the tube. For hemoglobin determination, use a sand-grain-type hemoglobin meter.
Correct Testicular Self-Examination Techniques: Gently hold one side of the testicle with each hand, using the thumb to lightly touch while the other fingers move simultaneously to thoroughly check for lumps or abnormalities in sensation or appearance. The epididymis is located behind the testicle and has a slightly harder texture, which may be mistaken for a tumor. If swelling or tenderness is observed, consult a doctor immediately.
3. Semen Analysis
Introduction to Semen Analysis: General semen characteristics are observed with the naked eye, including color, transparency, viscosity, and liquefaction time. The volume of semen is measured using a graduated cylinder.
Normal Values for Semen Analysis: Normal range with a grayish-white color, becoming translucent milky white after liquefaction. Individuals who have not ejaculated for a long time may have a pale yellow appearance. Freshly ejaculated semen quickly coagulates into a gelatinous state, gradually transforming into a liquid over time. This period is known as liquefaction time. Under normal conditions, semen liquefies within 60 minutes.
Clinical Significance of Semen Analysis: General semen examination helps diagnose male reproductive capacity and reproductive system diseases.
4. Prostatic Fluid Examination
The prostate is one of the sexual glands, secreting prostatic fluid. Prostatic fluid is a viscous, milky-white, translucent, and thin liquid, one of the components of semen. Routine prostatic fluid examination generally involves observing its appearance and microscopic examination.
The main purpose of microscopic examination of prostatic fluid is to check for the presence of cells, lipid bodies, trichomonads, sperm, tumor cells (requires staining), amyloid bodies, and bacteria.
Normal Values: Under normal prostatic fluid microscopy, a large number of lipid bodies are visible, evenly distributed. Leukocytes are 0–2 per high-power field (HPF). A small number of epithelial cells from the prostate and urethra may be seen, and amyloid bodies may occasionally appear, more common in the elderly. Sperm may occasionally be observed.
Clinical Significance: When prostatitis is mild, the appearance of prostatic fluid shows no significant changes. With more severe inflammation, it may appear purulent or purulent-hemorrhagic, with increased viscosity, yellow color, turbidity, or. In prostatic cancer, prostatic fluid often shows varying degrees of blood-tinged appearance. Mild prostatitis is characterized by leukocyte, often exceeding 10 per HPF, which may appear in clusters; epithelial cells increase, while lipid bodies decrease. Severe inflammation shows a large number of leukocytes and epithelial cells, along with varying numbers of red blood cells, a significant reduction in lipid bodies. In cases of seminal vesiculitis or prostatic cancer, a large number of red blood cells may be observed in prostatic fluid. Trichomonas prostatitis may show trichomonads.
Requirements: Prostatic fluid is collected using the rectal finger massage method and placed directly on a glass slide, covered with a cover slip, and sent for examination immediately to avoid drying.
5. Sexually Transmitted Disease Examination
For male patients, additional examinations include a urogenital system examination, primarily through visual and tactile methods.
① Check for dermatitis, ulcers, or secretions in areas such as the coronal sulcus of the penis, external urethral orifice, inner side of the prepuce, edge of the prepuce, frenulum of the glans, and scrotum. Use a fine cotton swab to collect secretions for pathological examination.
② Perform tactile examination of the testicles, epididymis, and spermatic cord, carefully checking the head, body, and tail of the testicles and epididymis, comparing both sides.
If necessary, male infertility examinations may also include ultrasound, blood pressure, and cholesterol tests. If a married couple has been living together without children and the wife has been examined with no issues, the male should promptly seek medical attention to identify the cause or etiology for early treatment. The following examinations can be conducted sequentially in the urology or male department of the hospital: