sperm

Male Infertility and Major Diagnostic Tests-Sperm quality responsible for infertility, RSAs, and Failed IVFs

Reproduction (or making a baby) is a simple and natural experience for most couples. However, for some couples it is very difficult to conceive. It has been proven that the reason of infertility in about 50% is the male factor.

A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy.

The couple has to know how to filter data that reads that to exclude that the male sperm is responsible for their infertility because less tests are available that if husband is the problem, it takes more time for sperm’s treatment than woman’s tests, which are more expensive and treatment takes less time.  So, the couple has to be very careful when searching for their infertility reasons.

What causes male infertility?

Causes of male infertility
In this section, we list a number of causes of male infertility:

  • Hormonal disorders
  • Chromosomal defects
  • A deficiency in testosterone production
  • Infection – Infection can cause inflammation of the male testicles, urethra, or prostate, harming sperm production or movement
  • Sexually transmitted diseases (STDs)
  • A male birth defect called hypospadia where the urinary opening is located on the underside of the penis, rather than the tip.
  • Retrograde ejaculation where the sperm enters into the bladder rather than out of the penis after ejaculation.

Also, your partner’s testicles must be exposed to the proper temperature in order for sperm production to occur. Two conditions that may not allow this to happen include:

  1. An undescended testicle, which keeps the testicles close to the higher body temperature and does not allow them to be cooled properly
  2. A varicocele, a condition where a swollen vein in the scrotum doesn’t allow for cooling of the testicles, leading to reduced sperm count and motility

Lifestyle habits lead to male infertility
Certain lifestyle habits can also affect male infertility, including:

  • Smoking
  • Excessive alcohol consumption
  • Drug use
  • Being overweight or obese
  • Over-exercise
  • Poor diet

In addition, exposure to certain toxins, pesticides or lead can also cause male infertility. If your partner has been exposed to radiation and/or chemotherapy due to cancer treatment or for any reason, there can be a significant risk to his sperm production. Also, having a vasectomy may cause anti-sperm antibodies to form and attack sperm, leading to male infertility, which may cause problems if your partner wants to have a vasectomy reversal.

 

Male Infertility Diagnostic Tests

If a doctor suspects male infertility, he may run some tests to make a definitive diagnosis. Your partner may first undergo a routine physical exam and semen analysis. The semen analysis will analyze the number of available sperm, the shape of the sperm and its movement. If the semen analysis shows a problem, your doctor may recommend further testing.  Other tests for male infertility may include:

  • A semen culture to look for infection
  • A vital staining test to determine how many sperm are alive in a sample
  • A blood test that checks for abnormal hormone levels or genetic disorders
  • A sonogram of the scrotum to look for blockages
  • A testicular biopsy to see if sperm production is normal
  • A test for anti-sperm antibodies
  • A contrast dye test of the vas deferens to check for a blockage

Most important test for quality of genetic material of man is DNA fragmentation or DFI, where the level of fragmented sperm is tested and is very important for infertility, rapid spontaneous abortions (RSAs), and failed IVFs. This is because a poor genetic material of the husband can’t unite with the female genetic material and give a healthy embryo. This means that a normal sperm analysis maybe normal but it doesn’t mean that the genetic material is of good quality.  In other words, the regular sperm analysis is not enough to exclude that the husband’s sperm is ok to fertilize the egg.

In conclusion, the couple before the selection of fertility or IVF center MUST know how to filter the data, tests, services, references, and the moral and deontology of the doctors, so they can have the best chances to bring in life their baby.

References

Diagnostic evaluation of the infertile male: A committee opinion. Practice Committee of the American Society for Reproductive Medicine. Fertility and Sterility. 2015;103:e18.

Strauss JF, et al. Male infertility. In: Yen & Jaffe’s Reproductive Endocrinology. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. www.clinicalkey.com. Accessed June 16, 2015.

Swerdloff RS, et al. Evaluation of male infertility. www.uptodate.com/home. Accessed June 16, 2015.

Osman A, Alsomait H, Seshadri S, El-Toukhy T, Khalaf Y (2014) The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: a systematic review and meta-analysis. Reprod Biomed Online. Nov 13. pii: S1472-6483(14)00603-8. doi: 10.1016/j.rbmo.2014.10.018. [Epub ahead of print] Review.

 

 

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