Male Infertility

Диагностика при мъжа (спермограма)

Spermatogenesis is a process that lasts some 74 days and results from complex interactions of the hypothalamus, hypophysis and the testes. Problems in sperm output may reflect:

  • Pathological deviations in some internal secretion glands;
  • Chronic disease or medication (certain antibiotics, steroids and others);
  • Infection;
  • Environmental toxic impact;
  • Conditions and diseases impacting sperm output and normal ejaculation;
  • Anatomical issues (obstructions or abnormalities in the external genitalia);
  • Neurological issues (nerve damage or advanced diabetes);
  • Alcohol, marijuana or tobacco use;
  • Antobodies or abnormal sperm morphology.

Testing

Semen analysis: a basic test to determine sperm fertility. This is an easy, rapid, and exceptionally informative test. It covers a number of indicators, with deviations not necessarily indicating diseases. Only a complex analysis of data derived for all parameters and their dynamics over time allows good quality conclusions of male fertility.

The main requirements for semen analysis:

  • Abstain from sex for two to five days;
  • Do not take antibiotics for the two weeks prior to the test;
  • Do not use alcohol or narcotic drugs over the period of abstinence;
  • Do advise laboratory assistants of any medication and food additives you may be taking;
  • Use only sterilised disposable sperm containers;
  • Advise laboratory assistants if some sperm failed to enter the sterile container;
  • Please book ahead.

Sperm DNA Fragmentation: this test offers information on sperm DNA structural integrity. DNA integrity is an important indicator of sperm quality and fertility. SDF test results are independent of semen analysis.

This test is recommended:

  • When the reasons for sterility are otherwise unclear;
  • When many artificial insemination attempts have failed;
  • When embryo quality is poor;
  • After a number of spontaneous abortions;
  • When varicocele is present;
  • In males over the age of 45;
  • When sperm has been preserved by freezing;
  • When body temperature has been raised for the three most recent months.

MAR Anti-Sperm Antibody Testing (АSА): this test detects the percentage of IgA and IgG anti-sperm antibodies whose elevated values indicate immunological issues causing infertility. ASA testing is recommended in men and women suffering sterility with otherwise unclear reasons, chlamydia or other genital infections, and men whose semen analysis has indicated aglutinates or who have undergone surgical interventions of the reproductive organs.

HBA (Sperm-Hyaluronan Binding Assay) Testing: this test determines sperm functional maturity.

Vitality Testing: this test is indicated where semen analyses show a large percentage of immobile sperm. It offers the opportunity of determining how many immobile sperm are able to survive.

Sperm Biological Testing: this determines the percentage of moving sperm after processing and incubation over 24 hours.

Sperm Cryotolerance Testing: this test determines sperm ability to survive freezing and thawing. It is mandatory when sperm is to be frozen.

Treatment:

  • Treating basic endocrinal conditions, antibiotic therapy in infections and removal of harmful environmental factors;
  • Abnormal sperm numbers and sperm mobility may sometimes respond to hormonal treatment or surgical intervention;
  • Intracytoplasmic Sperm Injections (ICSI) has become a basic method of treating male factor infertility in recent years. It is the technique of choice when prior treatment has failed.
  • When there is no sperm or the family pair does not wish to undergo ICSI, the technique of choice is intrauterine insemination using donated sperm.