In couples who cannot have children, the problem may not be solely with the woman. Studies show that approximately 90% of infertility cases... %20–30’unda sadece erkek kaynaklı, %35–40’ında ise hem kadın hem erkek faktörlerinin birlikte rol oynadığını gösteriyor. Yani infertil çiftlerin yarısında erkek faktörü etkili oluyor. Bu nedenle detailed evaluation of the man It is of great importance.
Causes of Male Infertility
The main factors that can lead to infertility in men are:
Varicocele (enlargement of the testicular veins)
undescended testicle
Testicular inflammation (orchitis), chronic prostatitis
Hormonal disorders
Genetic anomalies
Testicular or groin surgeries
sexually transmitted infections
History of chemotherapy and radiotherapy
Smoking, alcohol, drug, and anabolic steroid use.
Prolonged excessive heat (sauna, hot bath)
Diabetes, kidney and thyroid diseases
👉 The most common causes: Varicocele, hormonal disorders, genetic anomalies, and testicular inflammation are among the causes.
Medical History and Examination
The first step is a detailed history (anamnesis) and physical examination.
Points to consider in the anamnesis:
Mumps, meningitis, and febrile illnesses experienced in childhood.
Undescended testicle, inguinal hernia surgery, hypospadias
History of premature birth
Testicular pain, sexual dysfunction
Lack of hair growth or breast tissue enlargement
The following were examined during the physical examination:
Secondary sexual characteristics (hair growth, breast development, etc.)
The size, location, and motility of the testicles.
Abnormalities in the epididymis and sperm ducts
Scars from previous operations
Basic Tests
Semen Analysis (Spermiogram)
This is the basic test given during the initial application process.
Sperm count, motility, shape, and volume are evaluated.
Least Twice (4–6 weeks apart) It should be done.
Having the analysis performed by experienced embryologists in an IVF laboratory increases its reliability.
Radiological Examinations
Scrotal Doppler USG: For varicocele and testicular structure.
TRUS: For sperm duct blockages.
MRI: When a detailed anatomical assessment is required.
Hormonal Evaluation
Testosterone, FSH, LH, Prolactin, E2 are measured.
Hormonal imbalances directly affect sperm production.
For example, hypogonadotropic hypogonadism can be treated to enable natural pregnancy.
Genetic Tests
Karyotype analysis: For anomalies such as Klinefelter (47,XXY) syndrome.
Y chromosome microdeletion test: For problems in AZF regions.
Cystic fibrosis gene test: In cases of suspected congenital absence of sperm ducts.
Advanced Sperm Tests
DNA Damage Test: High fragmentation is associated with miscarriages and failed IVF attempts.
Sperm FISH Test: It indicates abnormalities in the chromosome structure.
ROS Test: It measures the level of oxidative stress in sperm.
HBA Test: It indicates the sperm's ability to bind to an egg (used in the PICSI technique).
✨ Conclusion:
Male infertility can stem from a wide variety of causes, and a single sperm test is not sufficient to make a definitive diagnosis. A thorough history, physical examination, and further investigations as needed are necessary for an accurate diagnosis. Individual assessment for each patient. When done, it increases the chances of a healthy pregnancy, both naturally and through assisted reproductive techniques.
