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Fertility Test for Men

| 08 May 2020 | 2147 Views |

Your doctor and clinic should inspect to analyze your sexual behavior and come out with the suggestion to increase the possibility of having a baby before fertility inspection. There are many couples, in whom no particular reason is detected (infertility was unsolved)

Remember that, infertility tests can be costly and often indulges complicates treatments. Some medical treatments might not bear the expense of fertility treatment. In conclusion, there is no surety that even after all Fertility tests for men and consultation- — you can get the happiness of parenthood

Male Fertility Test

Well, if Male Infertility is considered then, it needs the testicles to generate sufficient healthy sperm. The healthy sperm needs to enter efficiently inside the vagina and reach the eggs. Tests for Male Infertility are conducted to search whether any of these procedures are damaged.

You might have performed a general body inspection which includes the inspection of your genitals. The specialized fertility evaluation can include

Imaging– In most cases, imaging evaluation such as transrectal or scrotal ultrasound, brain MRI or an inspection of vasography( vas deferens) might be conducted.

Genetic inspection – genetic impaction performed to identify whether there is a hereditary complication resulting in infertility.

Hormone test for male infertility – hormone testing is conducted to detect the level of testosterone and other male hormones. It will be identified by the blood test.

Semen evaluation – your surgeon will test one or more semen samples. Semen is carried out through intercourse and masturbation. It generally ejaculates from the testicle during masturbation and intercourse. A laboratory will examine your semen sample. In a few cases, urine might be inspected for the availability of sperm.

Testicular biopsy – in some rare cases, a testicular biopsy recommend conducting to determine irregularities to infertility or to extract sperm for assisted reproductive treatment such as IVF.

Other specialty testing. In many cases, other tests to determine the quality of the sperm might be conducted such as inspecting a semen sample for DNA defects.

What is a normal male sperm count?

In case, the sperm sample is lower than 15 million sperm per ML, then it Is measured as a low sperm count. Even if a person has a lower than 5 million, it is considered very low. This is called oligospermia in a technical definition. If a male has no sperm and then they are known as azoospermic. This is a surprising fact because semen in such males appears normal, but with the help of microscopic identification, the ailment is identified.

What is normal sperm motility?

Sperm motility is about detecting whether the sperm are moving properly or not. The sperm quality is more valuable than sperm count. As we have already told that capability of sperm moving is called sperm motility. There are two categories of sperm (1) that can swim and (2) that don’t swim. Those sperm that are able to float rapidly towards the egg and fertilize it are useful. Other sperm are no use. This is also one of the factors in the Male Infertility Testing process.

According to World Health Organization (WHO), Motility is categorized from A to D

Grade A (Quick Progressive): Sperms are capable to swim rapidly toward the egg but in a straight way.

Grade B (Slow Progressive): Those sperm that swims to the egg but in a crooked or bend line are come in Grade B. It also appears in the form of slow linear and non-linear motility

Grade C (Non-Progressive): Sperms only move their tails, but are not able to swim forward (limited motility merely).

Grade D (immotile): These sperms move their tails, but not able to swim forward (immotile)

Category of Grade C and Grade D is measured as poor quality if the motility is poor.

The term is called asthenospermia where testis generates poor quality sperm which doesn’t work accurately. It means that these sperm actually seems motile but they might not be capable to fertilize the egg.

The motility should be at least 50% so that the impotency of males can be treated, but when motility is 20%, then it becomes next to impossible to become a father naturally. There are several men suffering from low sperm count who generally ask their surgeon, If a single sperm is needed to fertilize the female egg and if the sperm count is ten million and motility is 20 percent, then it means that they have two million motile sperm, then what is the reason that female can’t be pregnant? But you need to understand the fact that even an infertile man with a low sperm count is often not operationally capable, but the fact is that they cannot fertilize the egg.

In short, when only 20 percent of sperm has motility and 80 percent are immotile and most of the sperms are not able to move forward, the operational efficiency of the remaining sperms is questionable. You can understand it by a simple example,” If in a showroom 80% of the apparel is outdated and inferior quality, then no consumer will show interest in that remaining 20 % of apparel, even when they look of good quality.

What is normal sperm morphology?

Sperm morphology is about the shape of the sperm. Generally, a good quality sperm should consist of the shape of the common oval head with a joining middle part and a long straight tail. If a large amount of sperm has irregular shapes then it is called teratozoospermia. In teratozoospermia, several sperm have shapes like the absence of tails, dual heads, extremely big heads, tiny heads, and round heads. It means that those sperms who don’t have normal shape are incompetent to fertilize eggs. While doing Diagnostic Tests for Male Infertility, most of the laboratories utilize Kruger’s “Strict” guidelines ( Designed in South Africa) for inspecting sperm regularity. The “perfect” sperms are counted as normal. A general sperm sample must contain a minimum of 4 percent of normal shape ( that means even if 96 percent abnormally shaped sperm is there, then they are admissible).

Sperm clumping or agglutination

With the help of a microscope, it is observed that the sperm attach together to each other in the group. This activity damages the motility of sperm and restricts sperms to move forward to the uterus and egg.

In short, one appears for the total count of “Good” sperms in the sample – the result of the total count, the increasingly motile sperm and the generally shaped sperm. This provides the gradually motile sperm and the regular shaped sperm count which is a basic catalog of the fertility capacity of the sperm. Hence, for instance, if a male has a whole count of 40 million sperm ml in which 40 percent are gradually motile and 60 percent are regular shaped then his progressively motile normal sperm count is 40 X 0.40 X 0.60 = 9.6 million sperm per ml. If the quantity of the ejaculation is 3 ml, then the whole motile sperm count in the whole sample is 9.6 X 3 = 28.8 million sperm.

What does the presence of pus cells in the semen signify?

If there are a small number of blood cells in the semen are considered normal, but the quantity of pus cells is in an increased form, then it is known as seminal infection. Unluckily, many labs cannot distinguish between pus cells and sperm precursor cells (these are generally present in the semen). This signifies that men are medicated with antibiotics for a sperm infection that actually doesn’t occur.

Some labs take the help of computers for semen inspection and it is known as CASA (computer-assisted semen analysis). However this inspection is considered more authentic as this test is performed objectively by a computer), however, there are many disputes about its authenticity. It is because several of the technical information has not been consistent and differs from clinic to clinic.

What if my sperm count is zero ( azoospermia)?

Some men are unlucky to have zero sperm count. This is known as azoospermia and but it is total distress as these males have a normal sex drive and they can ejaculate in a normal way and semen seems normal.

If the test reveals that your sperm count is zero, you need to consult the laboratory to re-evaluate again. It is necessary to ask the lab to inspect 2 successive semen samples, ejaculated within a 1-hour difference ((chronological semen investigation). The laboratory also needs to inspect the sample and analyze the pellet for sperm precursors. Some males have infrequent sperm present in the pellet which means they are not actually azoospermic. This is known as cryptozoospermia.

If the analysis is determinedly nil, then the next process is to detect the reason for azoospermia. There are 2 chances disruptive azoospermia; and non-disruptive azoospermia. Men with obstructive azoospermia have usual testes that generate standard sperm, but their entryway is obstructed. This generally obstructs at the height of the epididymis, and in these males and the semen quantity is standard, fructose is available, the Ph is alkaline and no sperm precursor’s cells are visible on semen inspection.

Some males have blocked azoospermia due to the nonappearance of vas deference. Their semen quantity is low at 0.5 ml or less, the fructose is unenthusiastic and ph is acidic. The inspection can be authenticated by the clinical test that shows the absence of vas deferens. If the vas deferens is found in these males, then the analysis is seminal vesicle obstruction

Males who have non-disruptive azoospermia have a normal entryway, but irregular testicular action and their testis are not capable to create normal sperm. Some of these males might have tiny tests on clinical tests. The testicular breakdown might be fractional which means that only some regions of the testes generate sperm, but the generation of these sperm is not sufficient to be ejaculated. Other males might have a whole testicular breakdown which means there is zero sperm formation in the whole testes. The single method to distinguish between comprehensive and fractional testicular breakdown is by conducting numerous testicular biopsies to example separate regions of the testes and send them for the pathological test.

But what happens when the sperm count is determinedly low? In such situations, other Fertility tests for males are recommended. These tests should search for the root cause of infertility.

What additional tests can be done for a man with an abnormal semen analysis report?

If a man has a low sperm count or abnormal semen sample then an additional test might be suggested that includes testis biopsy, blood test, and specialized sperm test.

Semen Culture Test

The semen sample is inspected for the appearance of bacteria and if it does exist, their compassion to antibiotics is defined. Understanding this test is difficult because it is easy to detect some bacteria in normal semen samples but the question is that “are these bacteria harmful or not’

Tests that evaluate the sperm capability to be successful for fertilization are mentioned below

Testing for acrosomal status

CASA – computer-assisted sperm analysis

HOS test – hypo-osmotic swelling test is performed for the identification of authenticity of the sperm membrane

Sperm DNA Fragmentation

Lab inspections that have come into existence freshly are sperm DNA Fragmentation assay and Sperm Chromatin Structure Assay (SCSA). These tests are done for the veracity of the DNA present in the sperm nucleus and hence the potential of the sperm to fertilize the egg.

About The Author
Dr. Richika Sahay

MBBS (Gold Medalist), DNB (Obst & Gyne), MNAMS, MRCOG (London-UK), Fellow IVF, Fellow MAS, Infertility (IVF) Specialist & Gynae Laparoscopic surgeon,[Ex AIIMS & Sir Gangaram Hospital, New Delhi]. Read more

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