Sperm screening testing
The spermiogram is the most reliable test for male infertility testing. It provides an accurate measurement of sperm count [in millions per ml], of sperm motility, size and shape as well as volume and composition of the sample.
In order for the results to be evaluated properly, the sample should be collected in a clean, dry container (usually a urine collector) either at home and delivered within half an hour to the laboratory or within the fertility unit at a place specially intended for this purpose. The sample is collected via masturbation, after abstinence from ejaculation for 3-7 days.
In the normal spermiogram, the number should exceed 15 million sperm per ml, with at least 40% of the sperm being high motility sperm. The number of normal forms should exceed 4% of all sperm. Also, the anti-platelet antibodies should affect less than 50% of the spermatozoa.
Repeated sperm examination should be performed if the first results are poor in order to exclude natural fluctuations in sperm quality.
If there is no sperm (azoospermia), this may be due either to seminal vertebral pore occlusion (sperm transporting tubes), or to the absence of semen production from the testes. In these cases a clinical examination by the doctor and evaluation of the hormone levels is required.
DNA Fragmentation Control (DFI)
If a man has a repeated unfavorable semen analysis, he must undergo an advanced test called sperm DNA fragmentation. This test evaluates the number of spermatozoa whose DNA has been damaged and which may affect fertilization.
This test is recommended for:
- men with white blood cells in their semen,
- men aged over 50,
- men with a history of prostatitis
- men with a history of diabetes mellitus,
- couples who were subjected to IVF with poor fertility results,
- couples who underwent IVF with poor quality embryos and residual growth,
- couples with a history of recurrent miscarriages,
- couples with a long history of unexplained infertility,
- couples with a history of multiple in vitro fertilization failures
If there is a high degree of DNA fragmentation of spermatozoa, there are currently modern techniques (IMSI, PICSI) we implement at the IVF unit of the MITERA maternity hospital with high success rates.
Treatment of azoospermia
Treating azoospermia requires careful evaluation and possibly search for sperm in the testis using a technique known as testicle biopsy. This is a small intervention in which the testicle is opened for the purpose of obtaining sperm, it is performed at a day clinic and does not require hospitalization. This sperm can be used for intracytoplasmic sperm injection (ICSI) during IVF. Prior to testicular biopsy, it is necessary to perform a male complete (karyotype) genetic check and check for some chromosome Y chromosome abnormalities (sex-linked chromosome) that will give evidence of the possibility of finding spermatozoa in the testis. In addition, if genetic abnormalities are found, the couple should be informed of possible genetic problems that can be inherited by a male child. The semen obtained with the testicle biopsy may be used fresh (the same day), or frozen in liquid nitrogen for later use.