Comprehensive Andrology Tests and Diagnosis

At PACE Hospitals, we specialize in advanced andrology diagnostics that help detect male reproductive and sexual health conditions at the earliest stage. Our expert team uses cutting-edge technology to evaluate fertility, erectile function, and other concerns, ensuring accurate diagnosis and personalized treatment for optimal health and well-being.

Commonly Performed Tests 

These are standard tests used in most patients:

Semen Analysis (Spermogram)

Semen analysis is the most important test used to check male fertility. In this test, a semen sample is examined in the laboratory to evaluate the number of sperm (count), how well they move (motility), their shape (morphology), and overall semen quality. Through this test, doctors can identify conditions like low sperm count (oligospermia), absence of sperm (azoospermia), or poor sperm movement, which may affect the ability to conceive. It also gives an overall idea of reproductive health and helps guide further testing or treatment.

Semen Culture Test

A semen culture test is done to detect infections in the male reproductive system. In this test, the semen sample from the patient is placed in a special medium to see if bacteria or other microorganisms grow. If an infection is present, it can affect sperm quality and fertility. This test helps doctors identify the exact organism causing the infection and choose the right antibiotic treatment, improving both reproductive health and chances of conception.

Hormone Profiling

This test involves a simple blood test to measure hormones that controls the male reproductive function. Testosterone is responsible for sperm production and sexual health, while FSH and LH regulate how the testes produce sperm and hormones. Prolactin levels can also influence sexual function and fertility. These tests allows doctors to identify issues like hormonal imbalance, low testosterone, or problems with the testes or brain (pituitary gland), which may be affecting fertility or sexual performance.

Testicular Ultrasound and Doppler Imaging

This is a painless imaging test that uses sound waves to create pictures of the testicles and surrounding structures. It helps doctors identify problems such as enlarged veins, fluid collection, infections, tumors, or structural-related abnormalities. The Doppler part of the test checks blood flow to the testicles, which is important for detecting conditions like reduced blood supply or testicular torsion. By showing both structure and blood flow, this test helps find the exact cause of pain, swelling, or fertility issues.

Penile Doppler Ultrasound

Penile Doppler ultrasound is used to evaluate blood flow in the penis, which is essential for normal erections. During the time of this test, a medication is given to stimulate erection, and ultrasound is used to measure how well blood enters and stays in the penile tissues. This helps doctors determine whether erectile dysfunction is caused by poor blood flow, leakage of blood, or other vascular problems. It is especially useful in identifying the underlying cause of erection problems and guiding the right treatment.

Sperm DNA Fragmentation Testing

This test checks the quality of genetic material (DNA) inside the sperm. Even if sperm count and movement appear normal, damaged DNA can reduce the chances of successful fertilization or lead to repeated pregnancy loss. This test helps to detect hidden sperm defects that may not be visible in routine tests. It is often recommended in cases of unexplained infertility or repeated IVF failure to select the most suitable treatment options for the patient.

Genetic Screening and Karyotyping

Genetic testing is done to identify any chromosomal or inherited abnormalities that may affect male fertility. Karyotyping is a laboratory test that analyzes the size, shape, and number of chromosomes in a sample of cells to detect genetic abnormalities, while other genetic tests can detect certain gene defects. These tests are useful in men with very low sperm count or no sperm in semen.

Transrectal Ultrasound (TRUS)

TRUS is a specialised imaging test used to examine the prostate gland and seminal vesicles. A small probe is gently inserted into the rectum to get clear images of these internal structures. This test helps detect conditions such as ejaculatory duct obstruction, prostate abnormalities, or cysts that may affect semen flow and fertility. It is especially useful in men with low semen volume or suspected blockage in the reproductive tract.

Post-Ejaculatory Urinalysis

This test is done to check for a condition called retrograde ejaculation, where semen flows backward into the bladder instead of coming out normally during ejaculation. After ejaculation, a urine sample is collected and examined for the presence of sperm. If sperm are found in the urine, it indicates that semen is entering the bladder. This test helps doctors identify the cause of infertility or dry ejaculation and plan appropriate treatment.

Anti-Sperm Antibody Testing

This test checks whether the body’s immune system is mistakenly attacking its own sperm. In some men, the immune system produces antibodies that bind to sperm and affect their movement or ability to fertilize an egg. By detecting these antibodies in semen or blood, doctors can identify immune-related infertility. This helps in deciding the best treatment options, such as assisted reproductive techniques, to improve chances of conception.

Nocturnal Penile Tumescence (NPT) Testing

This test is used to check whether normal erections occur during sleep. Healthy men usually have several natural erections at night without being aware of them. In this test, a device is placed around the penis before sleep to measure the number, strength, and duration of these erections. If normal night-time erections are present, it usually suggests that the physical structures are working well and the cause of erectile dysfunction may be psychological. If erections are absent or weak, it may indicate an underlying physical problem.

Intracavernosal Injection Test (ICI Test)

The intracavernosal injection test is used to evaluate blood flow and erectile function. During this test, some amount of medication is injected into the side of the penis to stimulate an erection. An andrologist then observes how quickly the erection develops and how long it lasts. This helps determine whether erectile dysfunction is due to poor blood flow, nerve issues, or other physical causes. It is a useful test for identifying the exact reason for erection problems and deciding the most effective treatment.

Advanced / Specialized Diagnostic Tests

Used in complex infertility or erectile dysfunction cases:

Dynamic Infusion Cavernosometry and Cavernosography (DICC)

DICC is an advanced test used to evaluate blood flow problems causing erectile dysfunction. During the procedure, fluid is infused into the penis to create an erection, and pressure measurements are taken to assess how well blood is retained. Imaging may also be used to see if there is any leakage of blood from the penile veins. This test helps doctors identify conditions like venous leak, where the penis cannot maintain an erection, and is usually recommended when other tests are not conclusive.

Cavernosography

Cavernosography is an imaging test used to detect abnormalities in the veins of the penis. A contrast dye is injected into the penile blood vessels, and X-ray images are taken to visualize blood flow. This helps identify leakage of blood from the veins, which can lead to difficulty in maintaining an erection. It is often used in selected cases of erectile dysfunction to pinpoint the exact vascular problem.

Vasography

Vasography is a specialized imaging test used to examine the vas deferens, the tubes that carry sperm from the testicles. A contrast dye is injected into these tubes, and X-rays are taken to check for blockages or obstructions. This test helps diagnose conditions that prevent sperm from being transported properly, which can lead to infertility. However, it is rarely used today and is usually reserved for specific cases where obstruction is strongly suspected.

Sperm Chromatin Integrity Test

This test allows doctors to determine how well the genetic material inside the sperm is packaged and protected. Even if sperm count and movement are normal, poor chromatin integrity can affect fertilization and embryo development. This test helps detect hidden causes of infertility, especially in cases of repeated IVF failure or unexplained infertility. It allows doctors to recommend more targeted and effective treatment options.

Acrosome Stimulation Test

This checks whether the sperm can properly release enzymes needed to penetrate and fertilize an egg. In this test, sperm are exposed to certain substances to see if this reaction happens normally. If the response is poor, it may indicate a functional problem with the sperm, even if other parameters like count and movement are normal.

Post-Coital Test (PCT)

The post-coital test is performed after intercourse to check whether sperm are present and active in the cervical mucus. A sample of cervical mucus is collected and examined under a microscope to see how sperm are moving. This test helps assess whether sperm can survive and function properly after entering the female reproductive tract. However, it is now considered less reliable and is rarely used in modern practice, as newer and more accurate tests are available.

Additional Urological / Functional Tests 

These are included in andrology evaluation depending on symptoms:

Urodynamic Testing

Urodynamic testing is used to evaluate how well the bladder and urinary system are working. It measures how urine is stored in the bladder and how it is released during urination. This test is helpful in men who have symptoms like difficulty passing urine, weak urine flow, or problems related to ejaculation. This test identifies bladder dysfunction or nerve-related problems, which helps doctors understand conditions that may indirectly affect male reproductive or sexual health.

Cystoscopy

This procedure helps to look inside the urethra (urine passage) and bladder using a thin, flexible tube with a camera. This can detect blockages, narrowing (strictures), prostate enlargement, or other abnormalities that may affect urine flow or ejaculation. This test is especially useful in identifying structural problems that could contribute to infertility or urinary symptoms, allowing doctors to plan the appropriate treatment.

Less Common / Emerging or Limited Use Tests

Valid but not routinely used in modern clinical practice:

Scrotal Thermography 

Scrotal thermography is a safe test used to measure the temperature of the scrotal skin using special thermal imaging. It helps detect abnormal heat patterns, which may indicate conditions like varicocele or inflammation. Since increased temperature in the scrotum can affect sperm production and fertility, this test can provide additional information about underlying issues. However, it is not commonly used in routine practice and is usually considered a supportive or supplementary test rather than a primary diagnostic tool.

Need more clarity on diagnosis?
Get Free second opinion from the best andrologists.

At PACE Hospitals, we are committed to providing our patients with the best possible care, and that includes offering second medical opinions with super specialists for treatment or surgery. We recommend everyone to get an expert advance medical second opinion, before taking decision for your treatment or surgery.