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Basic Diagnostics - Men

„Can it be the man, if we can’t get pregnant?“

It was previously thought that it was solely the woman’s “fault” if she couldn’t get pregnant. However, we now know that both men and women have an equal share of potential fertility issues. As a result, male partners are examined in parallel with the woman. In ideal circumstances, approximately 100,000 healthy sperm cells contend for a single mature egg cell before fertilisation occurs. The fastest and healthiest sperm cell wins the race. But what happens when not enough sperm are produced? Or, when the sperm cells are not able to reach the necessary speed?


Your partner’s “Fertility Report”: The Spermiogram

A spermiogram is a selective examination of a man’s fertility. Due to the variation of certain parameters, a low sperm concentration, for example, may turn out to be normal at a later examination. Therefore, if the result is at first abnormal, a follow-up check may be necessary (approximately 8-12 weeks after the initial examination). Factors that may influence male fertility include: psychological and/or physical stress, chronic illnesses, and smoking. Using a microscope, we create a “spermiogram”, in which we examine the following three parameters:

  • Sperm density
  • Sperm shape
  • Sperm mobility.

Types of Examination
In order to create your spermiogram, we require a sperm sample. Ideally this should be obtained in the practice, so that it’s less than 20-30 minutes old when it goes to the laboratory. A period of abstinence (a time without sex) of 3-5 days is required, so that the sperm density can be bestassessed. If your partner cannot or does not want to give a sperm sample at the practice, there are also other options available, which we will gladly discuss with you.


What happens if the sperm sample is abnormal?

Should several spermiograms show abnormalities, it is important to rule out a disease. If this is the case, you should make an appointment with your urologist.
There are different illnesses that could be the cause of these changes (i.e varicose veins in the testicles or infection). Although testicular tumours are very rare, they are more likely to be found in men with fertility issues than in those without.



An additional hormone test may be the next step

Should the spermiogram be unusual, we may also suggest examining your partner’s hormone balance. A blood test can identify possible hormone disorders and deficiencies (such as certain vitamins).


Type of Examination

Blood test



Testicular Biopsy (TESE): Sperm extraction from testicular tissue

What happens when there are too little or no sperm in the ejaculate? A sperm transport disorder or a weak sperm production in the testicles could be the cause. Even in this case, fertility treatment can be continued. With the help of the TESE procedure (testicular sperm extraction), in most cases it is still possible to retrieve sperm from the testicular tissue. Post procedure, the sperm is frozen to be used for artificial insemination (IVF/ICSI) at a later point. The testicular biopsy is performed under a short general anaesthetic by an andrologist, as an outpatient procedure.




Together for the child you want

Fertility issues are best overcome together, as a couple (or partnership). Why not come to an initial consultation together? You can even book an appointment online.

Book an initial consultation