It is recommended that, for the first visit with the andrologist, the patient comes accompanied by his wife in order to provide the most pertinent information on different factors related to his infertility.
The basic clinical aspects will be evaluated and other complementary studies will be carried out. Once the diagnosis is established, the andrologist will be able to determine the appropriate treatment in order to improve or normalize the semen. If this is not possible, recourse to assisted reproductive techniques will be considered.
During the first consultation, the andrologist will carry out a basic study consisting of:
1. Clinical history
A complete questionnaire on both the clinical and family history is obtained. The doctor will ask questions about the age, profession, emotional state of the patient, illnesses suffered during childhood and thereafter, the presence of allergies, smoking, drug and alcohol abuse, the frequency of intercourse, etc.
2. Physical examination
This exploration allows obtaining a large amount of very useful data and, in many cases, the definitive diagnosis. To do this, a first general examination is carried out to analyze secondary sexual characteristics, that is, distribution and quantity of facial, axillary, pectoral and pubic hair. thyroid gland and breast palpation.
Afterwards, a genital examination is carried out, observing if there are possible dermatological lesions or other abnormalities. The size, shape, consistency, and location of the testicles are assessed to rule out various abnormalities that may cause lower sperm production. Palpation is also used to detect the possible presence of testicular varicose veins that can cause a varicocele. Finally, a rectal examination is performed to assess the state of the prostate.
3. Evaluation of the seminogram
Semen can present great biological variations in the same individual and, for this reason, it is advisable to carry out at least two analyzes of the ejaculate on different days.
The results obtained from the analysis of the seminogram will serve either to delve more deeply into the quality of the sperm, with complementary diagnostic tests or to examine possible female causes of infertiliy, in order to establish a diagnosis and subsequent treatment.