Male Infertility Treatment
Diagnosis
When it comes to diagnose infertility, the history taking and physical examination is most important along with many other advanced technologies. Many believe that no abnormalities found in semen analysis guarantee normal sperm condition; however, semen analysis is not a sole parameter to represent the reproductive ability of infertility patient. The study shows that one third of patients whose semen analysis was normal turned out to have abnormality at sperm function or sperm DNA fragmentation. At MizMedi, we take utmost care to provide a correct diagnosis via systematic tests. MizMedi offers streamlined tests as follows:
History taking and physical examination with a well-trained and fully-experienced urologist to infertility.
Computer assisted sperm analysis (CASA)
The semen analysis remains the cornerstone of the laboratory evaluation of the infertile man. To compare different semen samples from the same patient with accuracy, it is important to maintain consistency in the duration of sexual abstinence (48-77 hours) before collection of the specimen. Increases in seminal volume and therefore total sperm count also increased with increased days of abstinence, but motility and morphology tended to be decreased. More than twice semen analysis is needed because there are many changes in results due to patient conditions although same abstinence period.
Hormonal test
The purpose of the hormonal evaluation of an infertile male patient is to identify endocrinologic disorders that adversely affect male reproduction and to gain prognostic information. Although male reproductive function is critically dependent on endocrinologic control, less than 3% of infertile men have a primary hormonal etiology. Infertile man with abnormal semen analysis, decreased libido, gynecomastia, blurred vision, headache, testicular atrophy can be suspected of a hormonal abnormality.
Antisperm antibody test
Sperm agglutination, decreased sperm motility, abnormal postcoital tests are suggestive of the presence of antisperm antibodies. Antisperm antibodies are detected in approximately 10% of males presenting with infertility of unknown origin. Risk factors for the development of antisperm antibodies include conditions that may disrupt the blood-testis barrier. e.g., ductal obstruction, infection, previous operation, testicular torsion, undescended testis, varicocele.
Chromosomal study and Y chromosome microdeletion study
Chromosomal study was conducted to determine the genetic abnormalities associated with male infertility. It is a test of whether there is a structural or numerical chromosomal abnormalities and microdeletion of Y chromosome mainly. It also is carried out to know the cause of infertility and gives information required for genetic counseling prior to artificial reproductive technology to the problem that a genetic abnormality is delivered to their offspring’s.
Scrotal ultrasonography
The main application of scrotal ultrasonography in male infertility has been for the diagnosis of varicocele. Scrotal ultrasonography can be useful to man who may be difficult to examine or have an equivocal physical examination. Also it can be applied for subfertile patient to rule out the presence of testicular tumors.
Transrectal ultrasonography (TRUS)
TRUS allows for the anatomic visualization of the prostate, seminal vesicles, and ampullary portion of the vas deferens. TRUS is indicated in azoospermic or severe oligoasthenoteratospermic patients with normal testicular biopsy result who are suspected of having ejaculatory duct obstruction.
Testicular biopsy
Testicular biopsy is very important to know the exact state of testis in azoospermic or severe oligoasthenoteratospermic patients. There are two types of testicular biopsy. The first is a diagnostic testicular biopsy utilized to differentiate obstructive from nonobstructive causes of azoospermia. The second is a testicular biopsy performed to harvest sperm to be used during IVF. The most commonly employed classification patterns are based on the appearance of spermatogenesis ranging from normal to Sertoli cell-only pattern with maturation arrest and hypospermatogenesis in between.
Sperm DNA fragmentation test via comet and halo sperm assay
  • Sperm DNA Fragmentation (Comet assay)
    Comet assay is a method for measuring stand breaks in DNA in individual sperm. Sperm appearing like a comet with a tail shows abnormalities. If more than 30% of such sperm is present in a test, it is considered abnormal.