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Male fertility • laboratory care

Andrology that connects the whole treatment plan.

RCA’s andrology work supports male fertility evaluation and the laboratory steps used in IUI, IVF and fertility preservation. Results are interpreted in clinical context—not as a diagnosis from one number alone.

What happens here

From sample to treatment decision.

A coordinated workflow helps the clinical and embryology teams understand the sample, select appropriate preparation methods and plan the next step.

01

Semen analysis

Evaluation may include volume, concentration, motility and morphology, with additional testing only when clinically indicated.

02

Sperm preparation

Laboratory techniques prepare sperm for IUI or IVF while the treatment team considers the complete clinical picture.

03

Cryopreservation

Planned sperm freezing may support fertility preservation, backup specimens or future family-building needs.

Look closer · Semen analysis

A sample. Several perspectives.
A clearer conversation.

Semen analysis examines the fluid and the sperm it contains. Explore each parameter to see what is measured and why the findings belong together.

Original educational illustration · Not a patient sample or diagnostic result.

Parameter 1 / 7

Volume

The amount of semen in the complete sample, usually reported in milliliters (mL).

Volume measures fluid, not sperm concentration. An incomplete collection can affect interpretation.

A question to bring: How is a missed portion of the sample documented?

One number is not a fertility verdict. Results can vary between samples; your clinician considers the complete report, collection details and medical history, and may recommend repeat testing.

Educational sources:ASRM: male fertility testing ↗WHO semen examination manual ↗

From collection to conversation

The process, at a glance.

  1. 01

    Prepare

    Follow the laboratory’s collection and timing instructions. Ask how to report incomplete collection, illness or relevant medication.

  2. 02

    Identify & examine

    The laboratory verifies identification, records sample characteristics and examines sperm using its testing procedures.

  3. 03

    Review the report

    Look at volume, sperm numbers, movement and shape together. Additional observations or tests may clarify a finding.

  4. 04

    Plan the next step

    Discuss whether repeat analysis, further evaluation or treatment planning is appropriate for your situation.

What else might be recorded?
pH
The acidity or alkalinity of the semen sample.
Liquefaction & viscosity
How the sample changes from a gel-like state and how readily it flows.
Round cells
Cells other than sperm; further testing may distinguish white blood cells from immature germ cells.
Agglutination
Sperm sticking to one another. Its significance depends on the full assessment.

This guide explains laboratory concepts. Your laboratory supplies collection instructions and your clinician interprets your results. Reference limits do not create a simple fertile/infertile boundary.

Reproductive urology · Understanding the cause

Beyond the sample.
A closer look at your health.

Reproductive urology investigates why sperm production, movement or delivery may be affected. A specialist connects the semen report with your history and examination, then chooses tests that can clarify the cause.

01

History & semen results

Your reproductive urologist reviews repeat semen testing, prior illness or surgery, medication and supplement use, exposures, and sexual or ejaculation concerns.

02

Physical examination

A respectful examination looks at testicular size, the sperm-carrying ducts, a palpable varicocele and signs of a hormone problem.

03

Targeted ultrasound

Imaging can clarify an examination finding or suspected obstruction. Scrotal or transrectal ultrasound is selected for a clinical question; it is not a routine requirement for everyone.

04

Hormonal workup

When indicated, FSH and testosterone help assess sperm production and hormone function. LH, prolactin or other tests may follow the initial findings.

05

Genetics & directed tests

Very low or absent sperm may prompt genetic testing and counseling. Infection, ejaculation or other specialized testing is guided by the history and results.

Some causes can be treated; others remain unexplained. The evaluation and any partner’s fertility assessment help shape the plan together.

Explore AUA/ASRM evaluation guidance ↗

Your evaluation pathway

One step at a time.
With a plan you understand.

Use this checklist to prepare for a reproductive-urology visit and the conversation that follows.

ReviewClarifyPlanReassess

Testing and reassessment are individualized. This pathway is a conversation guide, not a fixed schedule.

  1. Bring the full picture

    Bring prior semen reports, relevant health records, and a medication and supplement list.

  2. Confirm & examine

    Review sample conditions, repeat testing when needed, and complete a specialist examination.

  3. Choose focused tests

    Ask which blood tests, imaging or genetic tests will answer your specific clinical question.

  4. Discuss the cause & options

    Review what can be treated, what remains uncertain, and how the findings affect family-building choices.

  5. Agree on follow-up

    Set a reassessment plan and coordinate timing with the fertility team; not every evaluation follows the same timetable.

Care options · Matched to the cause

Different findings.
Different ways forward.

Treatment may address a contributing health factor, hormone signaling or a structural problem. Some people move directly to assisted reproduction; others benefit from targeted treatment first.

01 · Support

Health & contributing factors

Addressing relevant exposures, medication effects or a confirmed infection may be part of care. A clinician guides changes to prescribed medication.

02 · Hormone-directed care

Clomiphene & gonadotropins

Clomiphene (Clomid) is sometimes used off-label in selected men. Gonadotropins such as hCG, with FSH when appropriate, can support sperm production in specific hormonal disorders. Other hormone-directed medicines may be considered; benefits and monitoring depend on the diagnosis.

03 · Structural care

Repair & reconstruction

Selected patients may discuss repair of a palpable varicocele or reconstruction of an obstruction. The decision considers the findings, the partner’s evaluation, timing and assisted-reproduction options.

When sperm retrieval may be needed

Finding sperm beyond the ejaculate.

If no sperm are found in the ejaculate (azoospermia), a specialist evaluates obstruction versus reduced production. Surgical retrieval may be considered, with IVF/ICSI and freezing coordinated when appropriate.

Conceptual illustration · Not surgical instruction or a clinical image.

TESE

Testicular sperm extraction

A small tissue sample is taken from the testicle and examined by the laboratory for sperm. The approach depends on the cause of absent sperm and the surgical plan.

Discuss anesthesia, bleeding or infection, testicular injury or hormone changes, recovery, freezing and a backup plan. Retrieval can find no usable sperm and cannot guarantee pregnancy. These options are discussed with a reproductive urologist and coordinated with the fertility laboratory.

AUA/ASRM treatment guidance ↗ASRM sperm-retrieval guide ↗

Connected services

Where andrology fits into care.

The exact workup depends on history, prior results and the treatment being considered.

01

Male fertility evaluation

History, examination or referral, and semen testing are coordinated when male-factor questions may affect the plan.

02

IUI support

Prepared sperm is used for insemination according to the individualized treatment protocol.

03

IVF and ICSI planning

Laboratory findings help the team decide whether conventional insemination, ICSI or another approach is appropriate.

04

Quality and identification

Documented labeling, witnessing, handling and chain-of-custody processes are integral to laboratory work.

Educational information only. Semen-analysis values can vary, and an abnormal result may need confirmation or additional evaluation before conclusions are made.
Explore male fertility ↗Meet the team ↗

A coordinated next step

Bring both partners into the plan from the beginning.

RCA can coordinate the clinical and laboratory questions that affect a shared fertility path.

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