Fertility Screening

A Semen Analysis evaluates certain characteristics of a man’s semen and the sperm contained therein. The test is done as part of a couple’s infertility investigation or to verify the success of a vasectomy. It involves a combination of procedures to assess the semen quantitatively such as sperm concentration and qualitatively such as morphology, motility and vitality. Although this is a standard test, the diagnostic sensitivity is low and male factor infertility is frequently undetected. Approximately 15% of men with proven male factor infertility are found to have normal spermiograms. Accordingly, additional tests can be carried out to assess the functionality of the spermatozoa. Among them, the tests for the hyaluronan-binding ability (HBA), sperm DNA fragmentation (Halosperm), and sperm oxidative stress assay are simple and quick enough that the same semen sample tested can be used for the insemination of oocytes.

Spontaneous miscarriage occurs in 10–15% of clinical pregnancies in the normal fertile population but the rate is known to be higher in subfertile couples. Sperm DNA integrity is one of the important determinants of normal fertilization and embryo development. The Sperm Chromatin Dispersion (SCD) test, which is a simple, fast, and reliable procedure, is used to determine the frequency of sperm cells with fragmented DNA. The frequency of sperm DNA fragmentation is expressed as DNA Fragmentation Index (DFI). A sample with DFI <10% has high fertilization potential while a DFI >30% denotes poor prognosis for IUI and IVF treatment and the man will require clinical treatment to improve his sperm quality.

The seminal plasma is well endowed with an array of antioxidants that act as free radical scavengers to protect the spermatozoa against oxidative stress. Sperm that have been exposed to oxidative stress have reduce motility, lower capacity to sperm-oocyte binding and fusion, and sperm DNA damage. It is possible that excessive reactive oxygen species (ROS) generation by the human spermatozoa contributes to the aetiology of the male infertility. The result of such an oxidative stress is the induction of lipid per oxidation in the sperm plasma membrane, suppression of the sperm functions, and the precipitation of the DNA damage to both the nuclear and the mitochondrial genomes. Sincere Andrology Laboratory can perform an assay that is reliable and sensitive to measure a possible excess of superoxide anions present in the ejaculate.

The Sperm Hyaluronan Binding Assay is a qualitative assay for the maturity of sperm in a fresh semen sample. This additional information will help the attending physician to identify patients with poor reproductive prognosis in Intra-Uterine Insemination (IUI) and In- vitro Fertilization (IVF). It is not intended to be a single diagnostic indicator of potential fertility.

Sperm after washing and removal of seminal plasma are cultured for extended period of time. The motility of spermatozoa is then checked after 24 hours. The specimen is considered normal if more than 70% of the sperms are alive and moving at 24 hours.

A Retrograde Semen Analysis is indicated for patients with a low volume and a diminished sperm count in the initial semen analysis. Retrograde ejaculation is the ejaculation of sperm into the bladder. Urine released following sexual activity will contain sperm in men who undergo retrograde ejaculation. Many retrograde ejaculation patients will have had prior surgery or a medical condition that predisposes them to retrograde ejaculation, such as testicular cancer surgery (RPLND), transurethral surgery of the prostate, or childhood bladder surgery etc. Medical conditions such as diabetes, MS, or spinal cord injury may also predispose an individual to retrograde ejaculation.

Trial Wash and Freezability