Initial evaluation of the male partner includes a medical history, complete physical examination, and comprehensive patient education including the distribution of appropriate printed support information. In addition to semen analysis, initial evaluation may include an analysis of the blood levels of the hormones that control fertility. They are follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), and prolactin (PRL). If the man has normal size testicles, normal sexual desire (libido) and a sperm density of at least 10 million/ml, then the hormone profile is typically normal, and in such cases many doctors will not obtain a hormone profile. The initial evaluation may also result in the need for advanced sperm function tests such as the sperm antibody test (SAT) which looks for an immune reaction the man may be making against his own sperm, or the sperm penetration assay (SPA) in which the ability of the sperm to penetrate an egg and initiate fertilization can be assessed. Couple-oriented therapy is the governing principle of our approach. Treatment options offered at the follow-up consultations include a multiple factor analysis of the couple including wife's age, wife's fertility status, prior medical and non-medical reproductive history, and financial and personal moral/ethical considerations. This approach allows us to provide a cost-effective and timely individualized treatment plan in cooperation with the referring physician. Although many of our clients are physician referred, we see an increasing number of clients who refer themselves, often on the basis of an internet search!
Legacy Male Health Institute, P.A. offers a couple-oriented treatment therapy for infertility factors.
