How are diagnostics and treatment carried out for men?

Although fertility problems are often initially sought in the woman, a male factor is present in approximately 30–50% of cases. The guideline for the initial fertility investigation (OFO) of the Dutch Society of Obstetrics and Gynaecology therefore emphasises the importance of simultaneous evaluation of both partners.

The examination of the man begins with a thorough medical history. This includes, among other things, the medical background, past illnesses, medication use, and lifestyle. Factors such as smoking, alcohol consumption, diet, and stress can influence sperm quality and are therefore routinely included. Sexual health and patterns of intercourse are also discussed.

An essential part of the initial fertility investigation is the semen analysis. This involves assessing the quantity, motility, and shape of the sperm. If there are abnormal results, it is indicated to repeat the examination to get a more reliable picture. If necessary, further investigations will be carried out, such as hormonal diagnostics or imaging of the testes.

Additional diagnostics focus explicitly on identifying underlying causes. This involves examining factors such as hormonal imbalances, inflammatory processes, oxidative stress, and anatomical abnormalities. This approach allows for more targeted treatment.

The treatment of male subfertility typically begins with lifestyle adjustments. Improving diet, achieving a healthy weight, getting enough exercise, and limiting harmful influences such as nicotine and alcohol can have a positive impact on sperm quality. When specific abnormalities are identified, targeted therapy can be initiated. This may involve hormonal treatment for endocrine disorders, the use of antioxidants, or, in certain cases, surgical correction of conditions such as a varicocele.

In the fertility clinic, we therefore advise undergoing an initial fertility investigation for both partners at an early stage. Depending on the results, further investigations can take place at the clinic, or the couple can be referred to an andrology specialist for further diagnostics and treatment.