The very first step in testing the male partner is to analyze semen sample. We do this following the World Health Organization (WHO) 2010 standards. These tests are controlled by an independent control done by Quality Control Programme of the German Society of Andrology (QueDeGa).
The test includes the analysis of the following:
Sample volume: once the sample is entirely collected the volume of the ejaculate is an indirect indication of the work of male reproductive glands. The sample volume should range from 1.5 to 6 ml.
Sperm count: the acquired sperm count indirectly shows functioning of the testicles. The sample is put on a chamber and the sperm is counted on the net and their count is given per milliliter of sample. According to WHO criteria, sperm count should be equal to or higher than 15x106 per milliliter of sample.
Sperm motility: after doing the sperm count their motility is tested and the sperm is categorized in progressive motile, non-progressive motile and non-motile sperm. The overall portion of progressive motile sperm should be equal to or higher than 32%.
Sperm viability: sperm viability test is based on the principle that dead cells with a damaged membrane absorb color. The test is used to differentiate non-motile living sperm from dead sperm.
Sperm morphology: after coloring the sample smear sperm is analyzed according to established standards. The portion of morphologically normal sperm should not be less than 4%.
Sperm concentration: If the sample shows no sperm the entire sample is concentrated using centrifuge and the residue is checked to establish presence of cryptozoospermia or azoospermia.
WHEN DO WE NEED ADDITIONAL TESTING?
Microbiological testing – if the analysis of semen quality shows increased number of round cells or glued sperm (agglutination), we suggest doing microbiological analysis of urine and ejaculate. This test is done to establish whether an inflammation affects semen quality.
The HOS test is another test of viability and is done in addition to eosine viability test when the sample shows no motile sperm. The test is based on the hypo-osmotic principle. It is very important to establish the presence of living sperm because it is a precondition for an IVF procedure. The test is not toxic for the sperm so it is used to isolate the living sperm right before ICSI procedure.
The MAR test is a test used to establish existence of antisperm antibodies and find out their type (IgG, IgM or IgA).
Urologist examination and opinion – we instruct our patients to see an urologist in cases of:
– High asthenozoospermia (highly reduced number of motile sperm),
– Severe forms of oligoasthenozoospermia (low total sperm count),
– Cryptozoospermia and azoospermia.
Before instructing our patients to see an urologist we ask the patient to do at least two semen sample analysis in three months, a microbiological urine and ejaculate analysis and, if necessary, blood hormone levels (FSH, estradiol, testosterone).
After examining the patient and reviewing the test results the urologist will suggest further necessary diagnostic and therapeutic procedures.
If the sperm analysis shows no sperm in the sample (azoospermia) the urologist may suggest a patient to do biopsy of the testicles. Biopsy involves taking specimen of testicle tissue. A part of the specimen goes into diagnostic analysis and a part is cryopreserved. Should the diagnostics show existence of ripe sperm the cryopreserved tissue can be used for an IVF procedure.