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Mr Parijat Bhattacharjee, Private Consultant Gynaecologist, Harrow, Brentford, Northwood, London, UK / Media / Videos » Assessment Of Male Fertility

Assessment Of Male Fertility

Assessment Of Male Fertility
Posted on: 03-Jul-2026

This video, titled "Assessment Of Male Fertility" by Gynae Consultant, covers the recommended timelines for seeking a fertility evaluation, specific male-factor warning signs, and the clinical steps involved in testing and treatment.

When to Seek Help

  • General Timeline: For couples with a female partner under 35 and no suspected reproductive issues, it is recommended to try to conceive naturally for at least one year before seeking medical help.
  • Advanced Female Age: If the female partner is over 35, the couple should seek an evaluation after six months of trying, or even sooner.
  • Immediate Assessment: Men should seek evaluation right away—without waiting a year—if they have a history of specific risk factors, including:
    • Undescended testes at birth.
    • Previous surgery around the genitalia, including hernia repairs.
    • Past trauma or injury to the genitalia.
    • A history of sexually transmitted infections (STIs).

Initial Testing and Specialist Referral

  • Semen Analysis: The initial step is usually a semen analysis ordered by a General Practitioner (GP). Following World Health Organization (WHO) criteria, this test evaluates sperm count, motility (how well the sperm swim), and morphology (sperm shape).
  • Specialist Referral: If abnormalities are found in the semen analysis, the GP will refer the patient to a specialist, such as a fertility consultant, a urologist, or an andrologist.

Specialist Investigations

A specialist will conduct a physical examination of the genitalia and reproductive ducts, and may order further diagnostics:

  • Ultrasound Scan: An ultrasound of the testes and ducts to evaluate testicular size and check for any structural obstructions.
  • Blood Tests: Done to assess essential male reproductive hormone levels.
  • Genetic Testing: Performed to determine if a hereditary issue is causing the infertility and to assess the risk of passing that condition on to children.
  • Post-Ejaculatory Urinalysis: In rare instances, a urine test may be conducted after ejaculation to check for underlying conditions (such as retrograde ejaculation).

Treatment Pathways

Based on the underlying cause, a specialist may offer a range of solutions:

  • Medical or Surgical Management: Prescription medications or corrective surgery to address blockages or physical defects.
  • Assisted Reproductive Technology (ART): Referral for advanced procedures such as IVF (In Vitro Fertilization) or ICSI (Intracytoplasmic Sperm Injection).
  • Surgical Sperm Retrieval: In severe cases, sperm may be harvested directly from the testes or the surrounding reproductive ducts.