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Etiological Testing for Hypospermia
Imaging the urogenital system via an ultrasound is the first-line imaging test for hypospermia. This assessment will look out for testicular degeneration and any other testicular anomalies, but above all carry out a detailed study of the deep genital tract and glands using a high endorectal probe frequency. This examination makes it possible to visualize the vas deferens over their pelvic path and therefore to diagnose possible agenesis (absence of cells within organs) on portions not accessible to clinical examination.

Seminal chemistry is a second-line examination needed in the event of suspicion of abnormalities of the excretory genital tract. This examination consists of measuring biochemical markers of the prostate, seminal vesicles and epididymis and seminal plasma, which can indicate the level of damage in these areas and help locate the level of lesions in the cases of hypospermia. The biochemical markers that are measured are alpha-glucosidase (in the epididymis), fructose (in the seminal vesicles) and zinc, citric acid and/or acid phosphatase (for the prostate).

Depending on the severity of the hypospermia (volume ≤ 1 mL) a molecular study of the CFTR gene may be performed. This is done by a molecular "screening" method (high performance liquid chromatography under denaturing conditions (D-HPLC) followed by sequencing of the exons of interest, allowing to detect nearly 95% of mutations in this gene, and even discover new mutations. Following this molecular screening step, if variants of the CFTR gene are detected, the work of the geneticist will consist, using computer databases, in distinguishing whether this nucleotide variant corresponds to a polymorphism of the CFTR gene ( without consequence on the function of the CFTR protein ) or to a real mutation.

Furthermore, hyperthyroidism, an excess of of thyroid hormones, has been associated with reduced semen volume, reduced sperm density, motility, and morphology. Studies in humans show that an excess of circulating thyroid hormones during thyrotoxicosis results in asthenozoospermia, oligozoospermia, and teratozoospermia. These abnormalities frequently associate with semen alterations like reduced semen volume.

Seminal Chemistry
Seminal chemistry is a second-line examination needed in the event of suspicion of abnormalities of the excretory genital tract. This examination consists of measuring biochemical markers of the prostate, seminal vesicles and epididymis and seminal plasma, which can indicate the level of damage in these areas and help locate the level of lesions in the cases of hypospermia. The biochemical markers that are measured are alpha-glucosidase (in the epididymis), fructose (in the seminal vesicles) and zinc, citric acid and/or acid phosphatase (for the prostate). The levels of these biological markers are lowered in a variable manner depending on the level of damage to the genital tract.

==== CTFR Screening ==== Depending on the severity of the hypospermia (volume ≤ 1 mL) a molecular study of the CFTR gene may be performed. This is done by a molecular "screening" method (high performance liquid chromatography under denaturing conditions (D-HPLC) followed by sequencing of the exons of interest, allowing to detect nearly 95% of mutations in this gene, and even discover new mutations. Following this molecular screening step, if variants of the CFTR gene are detected, the work of the geneticist will consist, using computer databases, to distinguish whether this nucleotide variant corresponds to a polymorphism of the CFTR gene ( without consequence on the function of the CFTR protein ) or to a real mutation.