A couple comes in for an infertility workup, having attempted to get pregnant for 2 years. The woman, 37, has always had irregular menstrual cycles but is otherwise healthy

Question

The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago. The man has had two normal semen analyses, but the sperm seem to be clumped together. What additional test is needed? a. Testicular biopsy
b. Antisperm antibodies
c. FSH level
d. Examination for testicular infection

Answer 1

C
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A A testicular biopsy would be indicated only in cases of azoospermia (no sperm
cells) or severe oligospermia (low number of sperm cells).
B Antisperm antibodies are produced by a man against his own sperm. This is
unlikely to be the case here, because the husband has already produced children.
C The woman has irregular menstrual cycles. The scenario does not indicate that
she has had any testing related to this irregularity. Hormone analysis is
performed to assess endocrine function of the hypothalamic-pituitary-ovarian
axis when menstrual cycles are absent or irregular. Determination of blood levels
of prolactin, FSH, luteinizing hormone (LH), estradiol, progesterone, and thyroid
hormones may be necessary to diagnose the cause of irregular menstrual cycles.
D Examination for testicular infection should be done before semen analysis.
Furthermore, infection affects spermatogenesis.