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Evaluation

The evaluation will consist of an in-depth examination of your medical and surgical histories, as well as a brief physical examination. As a couple, you will be asked about your marital history and sexual partners, along with any histories of miscarriages, elective terminations, and pregnancies. Your partner is more than welcome to be present, as fertility is often an issue that affects you as a couple and may require a joint effort. In preparation for the initial consultation, please be prepared to discuss:

  • Any previous fertility treatment or testing
  • Any patterns of infertility on either side of the family
  • Developmental conditions that may have compromised fertility. This includes any history of testicular torsion/trauma, undescended testicles, precocious or delayed puberty
  • Systemic illnesses such as diabetes mellitus, multiple sclerosis, spinal cord injury, or any condition that may impair normal ejaculation
  • Any abdominal surgeries, such as a hernia repair, which could scar or injure delicate internal reproductive structures
  • Prior exposure to sexually transmitted diseases, which may also lead to scarring of the reproductive tract
  • Recent fever or exposure to gonadotoxins (chemotherapy, radiation, pesticides, workplace chemicals, exogenous androgenic steroids, excessive alcohol, tobacco, marijuana, or recreational drugs) or excessive heat (i.e., sauna or steam heat). Intratesticular sperm maturation requires approximately 72 days, so please take careful note of your illnesses and activities of the past 3 months.
  • Current medications, as some prescription drugs may interfere with sperm production

During the physical examination, your physician will thoroughly examine the penis and scrotum. The size and consistency of the testicles will be noted, along with any tenderness in the epididymis, and the presence of the vas deferens. It is also likely that you will be asked to stand and “bear down” (the Valsalva maneuver) to test for enlarged veins (varicoceles).

It is likely the doctor will order a male fertility panel, including hormone tests, genetic tests, semen tests, a scrotal ultrasound, and any other tests indicated by your physician at the time of the examination.

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