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Male infertility evaluation  

The male factor evaluation is normally done by a male infertility specialist or a urologist. Adequate history taking and general physical examination is of paramount importance. The main goal of evaluation is to identify the correctable causes, irreparable causes and most appropriate method of correcting them.
History taking:
o    Sexual history
o    Social history
o    Previous children
o    Childhood diseases
o    Injury, radiation, chemotherapy, toxins
o    Drug history
o    Medical or surgical problems
 General and local examination :
1.     Height, weight
2.     Features of Hypoganadotrophic hypoganadism
3.     Hormonal imbalance
4.     Varicocoele
5.     Hydrocoele
6.     Undescended  testes
7.     Anatomical abnormalities

Prevention and treatment :

As the saying goes prevention is better than cure. Avoiding the risk factors like, smoking, recreational drugs, alcohol, excessive heat and protection to testicles while into sports may prevent or reduce the risk of infertility.

Male Infertility Treatment:

Some of the cause can be correctable by medications to improve the count, treating the infections.  Surgical correction is needed in some cases of obstruction.
In cases where the above treatments are unsuccessful, or when the cause for male infertility is unknown or untreatable, IUI treatment or IVF treatment may be suggested.
Obstructive causes of post-testicular infertility can be overcome with advanced techniques like

  • Sperm retrieval
    • Testicular Sperm Extraction/Aspiration (TESE/TESA)
    • Microscopic Epididymal Sperm Aspiration (MESA)
    • Percutaneous Epididymal Sperm Aspiration (PESA) 
    • Electroejaculation (EEJ)

Drugs of some help:
Clomiphene citrate
Vitamin E
Low dose estrogen testosterone combination
Gonadotrophins :
Though the therapeutic use of antioxidants appears attractive, antioxidant benefits by various commercial supplements for fertility purposes are still to be investigated .
Despite the availability of so many treatment modalities and advanced techniques some of the patients remain untreatable, and for some it may be expensive. Then there is no alternative but to recommend donor insemination (AID).