Semen analysis

1

Normal

Abnormal

Female investigations

Repeat

2

Normal

Abnormal

3

Asthenospermia

Check antibodies

Azoospermia

Oligozoospermia

<5 million per ejaculate

Check cystic fibrosis carrier status and karyotype

4

Check FSH and testosterone

All normal

Obstructive

Raised FSH & normal testosterone

B

Spermatogenesis failure

Raised FSH & low testosterone

C

Complete testicular failure

Low FSH & testosterone

Hypogonadotrophic hypogonadism

5