Workup for male infertility

Male infertility is evaluated primarily with the semen analysis. Infertile men can be classified as hypogonadotropic, hypergonadotropic or normal gonadotropic. Even normal results on the semen analysis, however, can indicate male infertility. The presence of infections or sperm antibodies can diminish fertilizing capacity. Subtle biochemical abnormalities can result in defects in the sperm head that can be detected with the hamster oocyte penetration assay. A thorough evaluation of the male partner is necessary in all cases of infertility. Reevaluation is important in men with a normal semen analysis when no cause of decreased fertility is apparent or when therapy in the woman fails to result in pregnancy.