Semen analysis: This is done to find out the sperm count, shape and movement of the sperm. Semen is collected in the lab, in a special container given by the lab, through masturbation. The person is advised not to have intercourse for a few days before the collection of his semen sample.
Culture and sensitivity of the semen sample: This is done if the semen is found to have infection. Necessary antibiotics are given to cure the infection.
Anti-sperm antibodies: Tests are also conducted to check the presence of anti-sperm antibodies in the semen.
Hormonal Estimation: The amount of FSH, LH, Testosterone (male hormone), Prolactin and Thyroid in the semen is checked.
Blood tests: these tests are conducted to check the blood sugar level, cholesterol level etc.
For men, infertility is diagnosed by:
By detecting associated hormonal defects: Infertility may be caused due to lack of the thyroid hormone, excess of prolactin or imbalance of gonadotrophin. Therefore, a blood sample is collected, usually on the second or third day of menstruation to check the levels of FSH, LH, TSH (sometimes T3 and T4 also), prolactin, E2 (Estradiol), Testosterone, Androstenedion, Dehydroepiandrosterone, Dehydroepiandrosterone Sulphate17, a hydraxy progesterone, Cortisol etc.
Progesterone level: a blood sample is collected on the 21st day from menstruation to check the progesterone level in blood.
D and C: This is process in which a small sample of endometrium taken out from the uterus. It is then examined under the microscope. This test can also help to detect other disease conditions like infection of the endometrium, luteal phase defect etc.
Cervical mucous study: Progesterone causes the cervical mucous to thicken. Tests like Fern Test and Spinnbarkeit Test are conducted to examine the changes in the cervical mucous.
Detecting problems in the cervix: If the cervical mucous is too thick, the sperms cannot swim through it. This may happen due to improper quality of mucous, cervical infection, or presence of antibodies in the cervical mucous. The examination is done through the Post Coital Test (PCT). PCT is done within 2 - 12 hours of unprotected intercourse, to find out the presence of viable and motile sperms in the cervical mucous. For this the cervical mucous is examined under the microscope.
Ultrasonography: This detects the growth of the follicle, which contains the egg, till it reaches the stage of ovulation. Ultrasonography also determines the thickness of the endometrium. Any tumour or cyst in the uterus or ovary can be detected through ultrasonography. For better results, it is often done transvaginally.
Hysterosalpingography: It this test, a radio opaque dye is pushed through the cervix and an x-ray is taken immediately after that. It is done to find out if there is a blockage in any part of the fallopian tubes. The shape and size of the uterus, presence of any tumour or polyp in the uterus can also be detected by this method.
Hysteroscopy: A telescope like instrument, called hysteroscope, is used to see directly inside the uterus.Sometimes a small tube called cannula is also passed through the fallopian tubes to detect any blockage, and also to open the blocks.
Laparoscopy: An endoscope is put inside the body cavity to see the organs like uterus, ovaries etc. If done on the third week of a menstrual cycle, the corpus luteum can be seen on the surface of the ovary. It is a definite proof of ovulation. During laparoscopic visualization, other abnormalities like tumours on the surface of the uterus or ovaries, polycystic ovaries, endometriosis, pelvic infections, adhesions and blockages in the fallopian tubes can also be determined.
Laparoscopic Dye Test: While conducting laparoscopy, a blue colour dye is pushed through the cervix. This test detects blockages in the tubes and also the area of blockage.