Male Infertility

While great emphasis has always been placed upon female fertility factors, historically, much less effort has been put forth in evaluating the male's relationship to infertility. Current literature indicates that perhaps 40% of infertility cases are primarily due to problems in the male. The Women's Clinic, Ltd. has developed the following series of diagnostic tests to adequately evaluate male infertility components:

Semen Analysis

A complete semen analysis is done to determine the semen volume along with the quantity and quality of sperm present in the male ejaculate. A drop of freshly ejaculated semen is placed in a special counting chamber and observed under a high-powered microscope. Moving and non-moving sperm are counted. Other factors such as the forward progression of the sperm, the Ph, and the number of white blood cells present are observed. The shape, or morphology, of the sperm is studied using a special staining technique and high magnification using the strict Kruger criteria of shape assessment. This determines the amount and type of abnormal sperm forms. Most abnormally shaped sperm do not have the ability to fertilize the egg. This type of very sophisticated analysis allows close correlation with the sperm's ability to fertilize. Semen is also sometimes tested for infection with cultures.

Immunobead Testing

Some people have antibodies present in their bodies which are hostile to sperm. This can be thought of like an allergic reaction to sperm. These antisperm antibodies may be present in the man and/or woman. They are detected by the use immunobeads which are separately coated with three different antibodies: IgG, IgA and IgM. Blood, semen, cervical mucus and follicle fluid may be used for this test. The specimen is combined with each of the specialty coated immunobeads and the three bead-specimen mixtures are observed for an antigen-antibody reaction. This reaction would indicate the presence of antisperm antibodies, which antibody is involved and how significant is the problem, i.e. the percentage of binding. In all, three separate tests are done.

Male Endocrinology

Steroid hormones that are produced in a man's body affect sperm production and hence his reproduction and fertility status. These hormones are measured by blood tests. Some important male hormones are FSH, LH, Testerone and Prolactin. If blood tests show that a hormone is present in too low or too high an amount, appropriate therapy may be prescribed. Just as the female endocrine system plays an important role in fertility, so also do these male hormones.

The Women's Clinic, Ltd. is very proud of our state-of-the-art testing facilities for male infertility factors. We highly recommend consideration of these diagnostic studies on all new infertility patients. Our In Vitro Fertilization Program requires some of these tests on all first cycle candidates.

When dropping off a semen specimen at our office, please be sure it is labeled and that the seman analysis request form is completed, including the name of the physicians who should be sent copies of the report. Our office will contact you as the results become available. If necessary, the office may be phoned Monday through Friday from 8:15 a.m. to 3:30 p.m. at (610) 374-2214.

Male Infertility Facts

Most male infertility results in lowered numbers of sperm, decreased motility of sperm and/or decreased numbers of normal shaped sperm. As these parameters are decreased, the fertilizing capability of sperm also decreases, making pregnancy less likely. It is not always possible to determine the specific reasons for the altered semen parameters, but various causes include a varicose vein around the testicle, termed a varicocele. A chronic prostate infection can be present and is quite often totally without symptoms. Sperm antibodies typically form after men have had reversal of a prior sterilization. Each of these problems has specific treatments that can be rendered. Some men do not ejaculate any sperm. It has been recently found, however, that even these men will be found to have sperm located within the testicles or the tubules just outside the testicles, and can have these sperm obtained through a surgical procedure carried out through our office. All these parameters are studied with the use of a sophisticated and thorough semen analysis and where indicated, semen cultures and sperm antibody testing.

In order to assess the interaction of sperm and cervical mucus, a postcoital test is performed, otherwise known as a PK test or Huhner test. This is carried out around mid-cycle, several hours after intercourse. With this test, the cervical mucus is evaluated, along with determining the number of viable sperm that have been deposited during intercourse. This will then determine how well the couple interacts.