- Clinical assessment
- Detailed semen analysis
- Hormonal assays: hormones produced by the hypothalamus, pituitary and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems may also contribute to infertility. A blood test measures the level of testosterone and other hormones.
Scrotal and trans rectal ultrasound:A scrotal ultrasound can help to visualize obstructions or other problems in the testicles or supporting structures. In a trans rectal ultrasound, a small, lubricated tube is inserted into the rectum and helps visualize the prostate, and look for blockages of the tubes that carry semen (ejaculatory duct and seminal vesicles).
Post-ejaculation urinalysis:presence of sperm in the urine indicates sperms are travelling back into the bladder and instead of out of the urethra, during ejaculation (retrograde ejaculation)
Genetic testing:when sperm concentration is extremely low or sperms are absent, genetic causes are often suspected. A blood test can reveal whether there are any subtle changes in the Y chromosome or the cystic fibrosis gene. Genetic testing may be ordered to diagnose various congenital or inherited syndromes.
Sperm DNA fragmentation test:is a specialized test done on a semen sample to assess breakage or lesions in the genetic material of the sperm.
Testicular biopsy: This test involves removing samples from the testicles to detect if sperm production is normal. If it is, the problem is likely to be due to obstruction or blockage or problems of the sperm transport.