Evaluation of Male Patients

Evaluation of male patient

Male factor problems may be related to :

• inadequate or abnormal sperm production and delivery
• anatomical problems,
• previous testicular injuries, or
• hormonal imbalances.

The male partner provides a semen sample that is analyzed with a battery of advanced andrology tests in our fully-equipped laboratory. In addition to the standard semen analysis using Health Organization (WHO) criteria, we also analyze sperm to assess the number of motile sperm that can be extracted form the ejaculate.

Normal semen analysis

We encourage male partners to have their semen analyzed at our Laboratory so their samples can be tested against rigorous standards. In addition to the routine analysis of our morphology, motility, and concentration, some of the additional testing we perform on the semen includes:

• routine semen cultures to detect infections
• pre- and post-processing to determine what to expect for our IUI or IVF procedures
• testing for antisperm antibodies and for IgA, IgM, and IG antibodies
• long-term survival studies
• detection of biochemical markers in the semen, e.g., fructose testing and also additional diagnostic testing for patients with severe male problems e.g. Hos Test.

In cases where the semen analysis is normal, treatment will focus on the work-up of the female partner only. According to WHO a normal semen analysis includes:

• a sperm concentration of greater than 20 million sperm
• motility (movement) of greater than 40%, and
• a volume greater than 2cc.

Additionally, our laboratory uses the Kruger classification of more than 14% normal morphology.

Abnormal semen analysis

An abnormal sperm analysis is repeated first for verification. Typically, the male partner is referred to a urologist for evaluation. If the urologic evaluation is normal, results of the sperm count determine further treatment. For example, a total motile sperm in excess of 0.5 – 10 million would make intrauterine insemination an option. If the number is less than a 1 million, ICSI would be a better course of treatment.

Azoospermia

Azoospermia is a condition, where there is no sperm in the initial fluid. In most cases, it is caused by either primary testicular failure or hormonal, chromosomal or obstructive abnormalities. Patient need hormonal, urologic, genetic or ultrasonographic examinations to further evaluate the problem.

Sperm antibodies

Anti-sperm- antibodies are substances that attach to the surface of the sperm and may interfere with the ability of the sperm to move & penetrate the cervical mucus, or to fertilize an egg. They must be meet out when infertility is either unexplained, following an abnormal postcoital test, or when significant sperm coagulation is noted in the initial semen analysis. Our laboratory uses the immunobead technique to detect sperm antibodies. If they are detected, sperm washing in conjunction with IUI or IVF is considered.