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Médecine de la Reproduction

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When and how to perform a male fertility assessment in 2023 Volume 25, issue 2, Avril-Mai-Juin 2023

Authors
Laboratoire ZTP, Bagnolet, France
Centre de fertilité de l’Est parisien (CFEP), clinique Floréa, Bagnolet, France
* Tirés à part : J. Chammas

The first consultation of a heterosexual couple for infertility should lead to the prescription of a spermiological assessment. In the first instance, it consists of a spermogram and a spermocytogram. It will provide information on macroscopic and microscopic parameters. The survival migration test guides the MPA technique; the sperm culture and the clinical examination complete this assessment. In a second phase, we will be able to continue the analysis of the sperm with: the search for anti-sperm antibodies, the analysis of the seminal biochemistry, and the evaluation of the DNA fragmentation rate. Blood samples will enrich the exploration: hormonal assays of endocrine and exocrine testicular functions; genetic analyses (karyotype, search for micro deletion of the Y chromosome, search for CFTR variants and search for the MTHFR gene mutation). Finally, imaging will complete this exploration with an ultrasound and scrotal venous doppler, and an MRI of the urogenital carrefour. Fertility assessment in men must be early, exhaustive and oriented.