Male infertility Evaluation - Physical examination of Infertile male

The male partner can sometimes be overlooked when couples try to conceive.

The male factor is the sole cause in 30% of infertility cases.

Examining and evaluating the man is often invaluable in infertility management.

Physical Examination:

General body habitus

Disproportionately long extremities are seen in Hypogonadotropic hypogonadism
(Kallman’s syndrome ) or Klienfelters syndrome
The thyroid gland needs to be palpated.
Chronic Bronchitis can be associated with Congenital Epididymal dysplasia seen in Youngs Syndrome.
Situs inversus associated with immotile sperms seen in immotile cilia(Kartageners) syndrome.
Breasts are observed and palpated for
Nipple discharge may be seen with prolactin-secreting pituitary tumors in the breasts.
An enlarged liver suggests Hepatic Dysfunction, which may be associated with infertility due to altered sex steroid metabolism.

A local examination is often an opportunity to identify physical conditions such as Varicocoele(blood collection in the scrotum) which can impact male reproduction.
Men with large varicocele sustain a greater improvement in semen quality following varicocele surgery than men with small or subclinical varicocele.
The scrotal examination is performed. Use of an orchidometer to measure testicular size. Normal testicular volume ranges from 15 to 30 cm.
The testis should be firm inconsistency.
Small soft testis indicates poor spermatogenesis.
In general, testis that is normal in size and consistency usually have normal sperm production.
Whereas small-volume soft testis is associated with impaired spermatogenesis.
Bilateral Congenital Absence of Vas Deferens will have Azoospermia associated with low seminal volumes.
The penis and urethral meatus are examined for condylomata.
The location of the meatus is noted.
Severe hypospadias may result in inadequate delivery of semen into the vagina.

The examination is quick and painless and an important aspect of the male partner evaluation