The male fertility study: what is it?
As we’ve mentioned on other occasions, the male partner also plays a fundamental role in assisted reproduction as having children obviously requires two people. That’s why today we want to talk to you about what the male fertility study is and what tests are included in it.
Infertility affects between 15% and 20% of couples of reproductive age. It’s a problem that is clearly becoming more serious year by year, mainly due to the fact that women are continuing to delay motherhood and are having their first child at a later age than women in the past.
The majority of couples who haven’t been able to conceive after one year of trying are highly likely to have some fertility issue that is preventing them from getting pregnant. Statistically, when a couple arrives to an assisted reproduction clinic and undergoes fertility testing, it is found that 30% of cases can be attributed to issues in the male, the other 30% to issues in the female and the remaining 30% is a combination of male-female issues.
As we were saying before, today we’re going to focus on the male fertility study and explain to you what tests are generally ordered for the purpose of pinpointing possible issues in the male partner.
Basic tests included in the male fertility study
Medical questionnaire
Although this is not technically a test, the medical questionnaire is the first essential step to studying a patient’s case. It’s a step we complete at the first fertility consultation, during which the doctor will evaluate the patient by asking important questions about factors that could be compromising their fertility.
This initial assessment is extremely important for the patient’s medical file. It includes questions about family medical history and reproductive history, and previous and current illnesses. At URE Centro Gutenberg we always also ask the patient to provide us with any and all documentation from prior investigations or treatments, as this will help us to decide whether or not additional testing is needed in order to make a complete and thorough case assessment.
At the first appointment the doctor will also enquire about other important points such as lifestyle and dietary habits, as it has been shown that they also impact fertility.
Andrology assessment
Following the first appointment, and depending on the information given by the patient or from the documentation provided, it is possible that the doctor may suspect an issue in certain cases.
When this happens, the medical indication is to perform an andrology assessment or a physical examination on the male. The purpose is to rule out any potential pathology in the male’s anatomy that may be affecting his fertility, such as varicocele or cryptorchidism, for example.
Sperm analysis
The sperm analysis is the first fundamental test in the male fertility study. It involves analysing the male’s semen, and the methodology and standards of the analysis are updated periodically by the World Health Organization.
At URE Centro Gutenberg we always recommend undergoing this test with a specialised laboratory which, at the very least, examines the fundamental parameters. These minimum parameters include the quantity or concentration of spermatozoids present in the ejaculate, sperm motility and sperm morphology.
Abnormalities in these three parameters may vary in severity and are frequently associated with each other. The type and severity of the sperm abnormalities detected will allow the doctor to determine whether more advanced sperm analyses are needed, and they will also help the doctor to decide which fertility treatment is the most appropriate for each case.
Other diagnostic testing in the male fertility study
Depending on the findings from the tests and on each patient’s particular history, additional studies may be necessary in order to provide a good diagnosis and a solution for their fertility issue.
The additional tests that are most commonly ordered are the following:
Sperm culture
In the event that the sperm analysis finds microorganisms that point to a sperm infection, a sperm culture will be ordered to identify the infection.
Sperm infections are the invasion of pathogenic microorganisms that are produced in some part of the male reproductive and urinary apparatus, meaning they can be present in semen and affect the male’s fertility.
Fortunately the majority of these infections can be treated with antibiotics to reverse the problem, so the sperm culture is a simple but useful test when it comes to assessing the male’s fertility.
Sperm capacitation
Sperm capacitation, also called REM (Recovery of Motile Sperm), is a test that complements the sperm analysis and which provides us with very important information: the number of spermatozoids with high potential to fertilise the egg.
The motile sperm count obtained through this test will help the specialist to select the most appropriate assisted reproduction technique. This decision will of course also depend on the female partner’s clinical situation as well.
Hormone analyses
Hormone analyses are carried out when, in certain cases, we encounter abnormal sperm samples. If this takes place we request a male sex hormone panel (FSH, LH, testosterone…), which will allow us to rule out a pathology that is caused by a hormone abnormality.
Karyotyping
Statistically, we know that there are certain genetic causes responsible for infertility and which are present in approximately 10% of males with severe sperm issues. We’re talking about cases such as azoospermia, an absence of spermatozoids in the semen, or cryptozoospermia and oligoasthenozoospermia which also involve severely abnormal sperm values.
These situations are when additional investigations, such as chromosome karyotyping or the Y chromosome study, are indicated. They help us to pinpoint problems and find alternatives for dealing with them.
DNA Fragmentation
The sperm DNA fragmentation study is indicated in cases of fertilisation failure, poor embryo quality, recurrent miscarriage and low success rates in previous cycles. This test measures an additional parameter regarding sperm quality which, when higher than normal, has a negative impact on the likelihood of reproductive success.
Sperm FISH
The last test included in the male fertility study that we want to speak about today is the sperm FISH analysis. This is an analysis we request when there is a severe sperm abnormality such as, for example, a low sperm count (oligozoospermia). We also tend to request this test in cases where the couple has had several unexplained miscarriages or failed cycles of in vitro fertilisation.
The sperm FISH test studies the number of chromosomes in a sample in order to determine whether the chromosomal makeup of the spermatozoids is normal or abnormal.
More information about diagnostic testing for males
As you can see, at an assisted reproduction clinic such as URE Centro Gutenberg we strive to analyse each case in detail. The tests we’ve explained here help us to achieve this objective, as each of them focuses on specific situations in order to determine the root cause of one or several fertility issues.
On our webpage you can find more information about diagnostic testing for males. Additionally, by clicking on this same link you can explain your situation to us if you think you may have a fertility issue that is preventing you and your partner from conceiving.
