An insight into male fertility testing

By Dr Andrew Zuschmann, Director and specialist at City Fertility Sydney Miranda

It can be daunting to agree to a male fertility check but these tests and subsequent treatment may just make the difference in helping you become a parent one day.

Although fertility issues are often attributed to the female, the truth is that around 30 per cent of infertility concerns are due to a male-factor fertility issue.

Male infertility issues are more common than you would expect.

When a couple is having trouble conceiving a fertility specialist will begin by running a set of tests on both partners in an effort to pinpoint the issue and devise a tailored treatment plan.

It is important to know that anyone can be affected by infertility and while it can be a challenging experience, the good news is that despite several conditions there are options available to help you try and achieve a baby.

So here is an insight into the more common male fertility tests undertaken:

• Basic physical exam: this is primarily to check overall health.
• Semen assessment: A semen assessment evaluates the amount and quality of a man’s semen and sperm to determine his potential fertility. This test is sometimes called a sperm count and is used to assess: the motility – movement of the sperm (swimming ability); the morphology – percentage of sperm that have a normal shape; the count – the number of individual sperm present in one ejaculation; and the vitality – the sperm’s ability to live and endure. A severely low sperm count or low motility may indicate the need for an advanced approach, whereas a normal semen assessment might suggest a more conservative strategy.
• Blood test: A blood test is undertaken to assess levels of hormones such as follicle-stimulating hormone (FSH), luteinising hormone (LH) and testosterone.

Depending on the results from the above, the specialist may request further tests including:

• Sperm DNA fragmentation test: A sperm DNA fragmentation test provides a reliable analysis of sperm DNA integrity and may help to identify men who are at risk of failing to initiate a healthy, ongoing pregnancy. The genetic integrity of the sperm is essential for normal embryo development. A high level of DNA fragmentation in sperm cells may represent a cause of male infertility that a conventional semen assessmentwill not detect.
• Immunobead test: An immunobead test (IBT) checks for anti-sperm antibodies. Immunological infertility occurs most often in men. The male immune system can react to its own sperm as if they were invading cells, possibly because of an infection, cancer or a vasectomy. The presence of antibodies can inhibit the ability of the sperm to fertilise an egg.
• Testicular biopsy: a testicular biopsy is performed when the male partner does not have sperm in his seminal fluid. This could be due to a number of factors, including a vasectomy, failed vasectomy reversal, obstruction, retrograde ejaculation, abnormal anatomy (such as an absence of the vas deferens) or certain genetic defects. Sperm are produced within a network of tiny tubes called “seminiferous tubules” inside the testicles. In the TESA procedure, a fine needle is passed into the testicles under anaesthetic, and a tiny amount of tubules is removed. These tubules are then processed in the laboratory and checked for the presence of sperm, which, provided they are viable, can either be used to fertilise eggs or frozen for use. Sperm retrieved from the seminiferous tubules in a testicular biopsy procedure are lower in quantity, less mature and less motile than those found in ejaculated seminal fluid. As such, IVF with ICSI is necessary to achieve fertilisation with TESA sperm.
• Other less common screening tests and diagnostic checks for severe male infertility can include:
  • Genetic testing (chromosomal)
  • Microdeletion
  • Nuclear chromatin fragmentation
  • Hormonal screens
  • Cystic fibrosis screening.

To find out more about male fertility tests visit our page on male fertility testing

If you have any questions or would like further information, please contact our friendly team on 1300 354 354 or email: contactus@cityfertility.com.au