Today, semen analysis confirms some kind of complication in up to 50 % of all couples. Male infertility is now considered as an equally important cause for infertility of couples as the female factor.
In assisted reproduction centers, it is the andrological outpatient clinic that treats male infertility.
Semen analysis parameters and sperm production disorder
Parametre Male infertility or problems with conception in men are manifested primarily by deteriorating sperm quality. Semen analysis parameters are deteriorating steadily in today’s population, and compared to mid-20th century data, the standards in semen analysis had to be reduced repeatedly. In general, however, we can blame the world we currently live in for the increasing infertility – the work, the air pollution, the food we eat, smoking, and, of course, stress.
Regarding the treatment of the male infertility factor, the assessment and testing must rule out inflammatory diseases, chronic infections, varicocele, and hormonal problems. In a small proportion of men, hormonal treatment is indicated – most often with antiestrogen drugs.
Initial test of ejaculate
The parameters of the semen analysis change with each test. Therefore the data is evaluated comprehensively by experts who take into account other tests as well. The differences between the respective samples can be very large, so it is always necessary to examine a new sample of ejaculate. We do not recommend making a premature conclusion from a single test only. Semen analysis can be performed after 3 to 5 days of sexual abstinence.
The basic analysis determines the following:
- volume, appearance, and liquefaction time of ejaculate,
- number of sperms per milliliter,
- assessment of sperm motility and morphology.
Specialized ejaculate tests:
- Trial wash test – separation of sperm from seminal plasma (the other part of ejaculate). Depending on how many sperms we can separate, we can better decide which of the methods of assisted reproduction is the most appropriate one.
- Test of sperm antibodies in the ejaculate – if sperm antibodies are present in the ejaculate, the chances of a spontaneous pregnancy are reduced even if basic semen analysis results are within the norm.
- HALOSPERM – a sperm DNA integrity test in which we detect the presence of sperms with damaged genotype as these sperms have a lower ability to fertilize the egg.
- Sperm DNA integrity test over time – Dyn Halosperm
- Oxisperm – ta test diagnosing sperm oxidative stress. Recommended in smokers, men with varicocele (dilation of blood vessels near the testicles), obesity and in negative environmental effects.
- Vital Test – a test distinguishing between the dead and the living non-motile sperms. In the conventional semen analysis, we cannot distinguish between the living cells that simply do not have the energy to move and those that are dead.
- SpermPack – a comprehensive semen analysis (concentration, motility, sperm morphology, sperm antibodies, sperm DNA integrity test, Oxisperm, Vital Test).
If you have recently overcame a febrile illness or have been taking antibiotics, it is better to postpone the test so that the results are not affected by the above factors.
Serious disorders of spermiogenesis
In very severe disorders of spermiogenesis, in vitro fertilization (IVF) is recommended. Assisted reproduction methods are able to solve the factor of male infertility with a high rate of success and it is a common practice that even the men who do not have a single sperm in their ejaculate can father their genetically own child after a surgical retrieval of sperm from the testicles and subsequent artificial insemination. The success rate of IVF with a male infertility factor is higher compared to procedures dealing with the infertility problems of the female partner.
- Surgical retrieval of sperm MESA/TESE
If no serious problem is identified, lifestyle measures will suffice
Studies show that 30 to 80 % of disorders detected by semen analysis are caused by oxidative stress and reduced antioxidant capacity of ejaculate. When a couple is trying to conceive a baby, it is necessary to stop smoking immediately, follow a healthy diet and avoid stress. Among antioxidants, we recommend vitamins C and E, coenzyme Q10, but also zinc, selenium, carnitine, folic acid, N-acetyl cysteine and many other preparations.
Infertility is not a purely male or female problem, it is always a problem faced by the couple
There is no fertility test that examines either the man or the woman while giving a clear conclusion as to which one is to blame. Fertilization is a very complicated process. The cause of infertility can be on the male side even if the basic semen analysis results are completely within the norm.