Sometimes, more than one reason for infertility could be found in the same case, so it's recommended to seek specialized medical consultation for doing some diagnostic examinations and lab investigations to find the cause of infertility; it include the following:

• Careful history taking and general examination, especially the issues related to the male genital system as well as any medical conditions could affect fertility such as hereditary diseases, chronic illness, injuries, surgeries… etc. also the doctor should ask about all the details related to sexual maturity since puberty.
• Semen analysis: the sample is obtained after 3 days of abstinence. This test is done for exclusion of any abnormalities related to the sperms (low sperm count, decreased motility, increased teratogenicity… etc.).
• Testicular examination by U/S with Doppler study: for detecting any damage related to the testicles especially in cases of varicocele or undescended testis.
• Hormonal profile: hormones secreted by pituitary gland and testicles play an important role in male sexual maturity and spermatogenesis. So any hormonal disturbances related to these glands may cause male infertility. For this reason, hormonal profile is an important diagnostic tool in cases of male infertility.
• Complete urine analysis immediately after ejaculation: this test is usually performed in diagnosis of retrograde ejaculation (it's a medical condition in which the semen passes during the ejaculation to the urinary bladder rather than coming out through the penis).
• Testicular biopsy: it's invasive procedure and less commonly used.

After detecting the causative factor responsible for male infertility, the doctor starts the management plan according to the findings of the diagnostic investigations as follow:

• Surgery: in cases of varicocele or resistant undescended testes.
• Medications: in cases of chronic infections (orchitis, epididymitis) or sexual transmitted disease (syphilis, gonorrhea).
• Hormonal treatment: in case of hormonal disturbance related to endocrine dysfunction (in pituitary, testicles, thyroid and parathyroid glands).
• Assisted reproductive techniques (ART) as IVF or ICSI: it's usually done if all above measures failed.