The tests are somewhat limited. We basically start off with the sperm test and if the sperm test is normal then there’s really no value, no evidence that there is any other test that would add value to um helping couples conceive. If a sperm test is negative, we don’t really recommend anything beyond that but if a sperm test is not normal, then there are various other tests that become applicable particularly if there are no sperm. If there is no sperm, then the man needs to have a range of tests to try and identify what the cause is for the lack of sperm. Is this a problem in the testes itself, is this a problem of obstruction between testes and ejaculation or is this a problem higher up perhaps in the brain, in the hypothalamus and pituitary gland. So in that situation the man would need tests for hormones such as FSH and testosterone and would need an ultrasound scan of the testes and yes, sometimes we do a karyotype to check if there is a chromosomal reason why sperm production isn’t happening and also you can do very specific tests on the Y chromosome because within the Y chromosome there can be what are called micro deletions which are abnormalities affecting a small part of the Y chromosome (that part which carries the genes responsible for sperm production). So those are the sorts of tests that a man might need.
