Since in 25-30% of infertile couples the problems lies solely in the male partner, the evaluation of the man (by an andrological examination) is mandatory.
The andrological examination always starts with an anamnesis (developmental disorders, previous diseases, and lifestyle) and a physical examination.
All these assessments are followed by a semen analysis. Ejaculated sperm is examined from several points of view, measuring for example the quality of sperm and liquefaction time, different biochemical characteristics, sperm concentration, mobility and shape. The normal liquefaction time is of 10 – 30 minutes, the normal quantity of the sperm is of 2 to 6 ml. The pH of the ejaculated semen varies between 7.2 and 8.0. A higher pH of the sperm can be the sign of an infection. Based on the criteria of the World Health Organization (WHO) we can consider that the ejaculated sperm has a good fertilization capacity if it contains at least 15 million spermatozoa per milliliter, of which at least half are mobile and at least 30% have a regular morphology. Prior to spermiogram testing a 3 to 5 days of sexual abstinence is necessary.
Based on the results, also a microbiological culture could be required from the ejaculated sperm, or other additional assessments could be useful in identifying the causes of male infertility, i.e. a testicular biopsy, the measurement of different hormones, chromosomal abnormality screening, and, if necessary, appropriate andrological therapies can be initiated.