The First Visit: Consultation and Workup Before Sperm Banking

The document from October 29, 2017, emphasizes the critical nature of a comprehensive initial consultation and workup prior to sperm banking. It outlines the necessity of evaluating a patient's medical, surgical, and reproductive history, as well as lifestyle factors that could influence fertility, such as alcohol and tobacco use. The document discusses how medications, especially those affecting the hypothalamic-pituitary axis, and physical conditions like varicoceles and testicular size, can impact sperm production and quality. It stresses the importance of semen analysis, which should be performed multiple times due to variability, and the consideration of World Health Organization standards, despite some controversy. Additionally, the document highlights the need for hormonal analysis, genetic testing, and imaging in certain cases to assess and optimize male fertility. It concludes that a thorough evaluation is essential for the best chance of preserving a viable sperm specimen, especially given the increasing age of childbearing and associated infertility risks.