What’s the evaluation and follow-up plan for men evaluating their fertility?

Here are some key categories to evaluate for men's fertility along with some action items and steps to take. 

1. Reproductive Health History: Key questions include but not limited to:
1. How long have you been trying to conceive?
2. Issues with erections or ejaculation?
3. Lubricant use during sex?
4. Any prior pregnancies?
5. Any history of testicular surgery?
6. Testicular infections?
7. Cancer requiring chemotherapy or radiation?
8. Other environmental exposures?
9. Lifestyle factors such as diet, exercise habits, smoking, alcohol, drug use?
10. Partner’s age and reproductive history?
    
    
2. Physical exam:
1. Checking for any male breast enlargement or abnormalities.
2. Making sure the tip of penis where urine/semen expel is open and in correct position.
3. Testicular size and volume measurements.
4. Making sure all the tubing important for sperm transport are present (i.e. vas deferens on both sides).
5. Checking for dilates veins of the scrotum (i.e. varicoceles)
   
   
3. Hormone testing: Just like in women, hormones are important for men. 5 critical hormones should be measured for a complete reproductive health evaluation. It’s important to check these hormones in the morning, between 8-10 AM when levels peak
1. Testosterone
2. Estradiol
3. FSH
4. LH
5. Prolactin
   
   
4. Semen testing: 2 semen analysis should be performed to evaluate your sperm quality. Why 2? Because there can be significant variability from sample to sample. Recommend 2-3 days of abstinence before each test
   
   
5. Avoid “wet-heat” exposures: Sauna, steam rooms, hot baths all can have a negative impact on sperm production. Even a single exposure can disrupt sperm counts for up to 3 months
   
   
6. LEV+LIV Fertility Force: Take 3 tablets daily to optimize sperm quality and quantity

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