Evaluation of Men

Evaluation of the man in couples applying for infertility problems is a process that begins with routine semen analysis and, in some cases, may require advanced tests and diagnostic operative procedures. Therefore, it is extremely important to choose a center that has a urologist specialized in this field.

Evaluation of Men at Liv Hospital

Liv Hospital provides detailed evaluation of male patients with its Andrology Laboratory, managed by a team specialized in reproductive health. Sperm analysis, evaluation of hormone levels, genetic testing and other andrological examinations are important components of Liv Hospital’s comprehensive and modern evaluation process for men’s reproductive health.

Accurate Information is Important for the Treatment Plan

During the initial examination, the following parameters are questioned and you are asked to provide clear, honest and accurate information so that the treatment can be planned properly.

• Infertility period (period in which pregnancy cannot be achieved despite unprotected sexual intercourse)
• Sexual dysfunctions (Erection problem, premature ejaculation)
• Previous illnesses that may affect reproductive health (infections, viral diseases, especially high fever diseases, prostatitis)
• Systemic diseases (liver, kidney diseases, diabetes, thyroid disorders) and medications used
• Known anatomical disorders in the reproductive organs (undescended testicle, varicocele, penis curvature)
• Information about previous diagnostic or operative procedures, if any (Semen analysis, varicocele surgery, orchiectomy)
• Family history of infertility, hereditary genetic disease
• Life style (Smoking and alcohol use, stress, eating patterns, working conditions-exposure to toxic substances)
• personalized treatment

After this verbal evaluation process, you will first be asked to provide a sample for semen analysis if it has not been done before or if it is older than 3 months. The sperm sample to be used for semen analysis is taken after 3-8 days of sexual abstinence.

This period is important in terms of obtaining the appropriate sperm count/viability ratio. Depending on the abnormalities observed in the semen analysis, detailed urology examination, blood tests and advanced semen analysis tests (which you can examine in the Andrology laboratory section) may be required.

Ultrasonographic Examination

During the urology examination, the size and position of the testicles, the presence and patency of the sperm ducts, the presence of enlarged veins in the scrotum (varicocele) and the prostate gland are examined. In cases of suspicion of varicocele and stenosis or obstruction in the sperm ducts, doppler ultrasonographic examination can also be performed.

Hormone Tests May Be Required

If a problem in sperm production (spermatogenesis) is detected during this evaluation and examination process (severe oligospermia, cryptozoospermia, azoospermia), blood tests may be requested to determine the levels of FSH, LH and testosterone hormones that govern spermatogenesis. The results of these tests and their ratios to each other can provide information about hypogonadism (lack of testosterone production from the testicles). Normal values for the mentioned hormone tests are as follows:

• FSH 1.7-12 ml/ml
• LH 1.1-7 ml/ml
• Testosterone 3-10 ng/ml

Hypogonadotropic hypogonadism, called hypogonadotropic hypogonadism, is one of the rare male infertility problems that can be treated with medication, due to the decrease in sperm production caused by low secretion of FSH-LH hormones from the pituitary gland. By taking external preparations containing these hormones, an increase in sperm production can be observed in an average of 6 months. Additionally, if necessary, peripheral karyotype analysis and Y chromosome deletion analysis, also taken from blood, may be requested to detect a possible genetic abnormality (such as Klinefelter syndrome).