A comprehensive systemic examination is essential during an infertility evaluation. Even a patient's general physical appearance can offer significant clues about underlying conditions. For instance, observations such as the absence of a receding hairline, lack of typical male frontal hairline indentations, or sparse to absent facial hair can indicate hormonal etiologies.

In addition to these initial findings, the examination should thoroughly assess:
* The presence of gynecomastia (breast enlargement).
* The development and distribution of body hair, including on the chest, armpits, genitals, and legs.
* The morphology of the penis and testicles.
* The presence of testicles within the scrotum.
* The existence of varicocele.
* The presence or absence of the vas deferens (sperm ducts).
* The presence of obesity, given its potential impact on fertility.