[Andrologic diagnosis today]

For the diagnosis of male fertility disorders, history-taking, physical examination and the semen analysis continue to be the main pillars of the initial investigative program. The physical examination frequently includes rectal and testicular ultrasonography. For the most part, considerable importance is attached to the accurate examination of sperm morphology. Additional investigations are, however, often required. Of importance here is a careful work-up of any inflammation presenting, the determination of spermatozoa antibodies, and a basic investigation of the hormones. Sperm function tests are increasingly being performed, the most important of which are acrosine activity, the acrosome reaction, chromatin condensation, and spermovum binding. The biochemical determination of specific marker enzymes, testicular biopsy and a detailed microbiological work-up round off the diagnostic program.