ABSTRACT
Infertility is defined as a couple’s inability to conceive following at least 12 months of unprotected intercourse. Approximately 80% of couples are able to achieve pregnancy within the first year. Therefore, the diagnosis of infertility should only be made after 1 year of unprotected sexual intercourse. In certain instances, earlier investigation can be started when couples present with risk factors. Typically, infertile males are uncovered in the setting of evaluation of their female partners, when a gynecologist, reproductive endocrinologist, or infertility specialist obtains a semen analysis. Examination begins with general assessment of the patient with focus on secondary sexual characteristics. Abnormalities in body habitus, hair distribution, and presence of gynecomastia can lend clues to underlying metabolic and genetic disorders that can lead to infertility. Semen analysis is an important initial laboratory test to evaluate male factor infertility. Standardized testing of semen analysis with population-based reference values is available, allowing for accurate assessment of sperm quality and comparison among different laboratories.
