There are many different factors that can affect male fertility. A semen analysis is the most important test used in the diagnosis of male infertility.
- History taking (previous diseases, smoking, weight)
- Blood sample testing for HIV and hepatitis B and C
The man must have his sperm quality examined.
If the sperm quality is severely reduced with a total number of spermatozoa below 3 million so that the treatment of choice is ICSI, we recommend further work-up of the man in order to detect possible causes of the reduced sperm quality.
The testing may include hormone analyses, an ultrasound scan of the testicles and a test for ‘micro-deletions’ on the Y-chromosome.
If the cause of the reduced sperm quality is a micro-deletion on the Y-chromosome, you should consider possible implications for the choice of treatment. For example, use of donor sperm may be considered because a defect on the Y-chromosome will be inherited by male offspring who will then inherit their father’s reduced sperm quality.
Men with azoospermia should also have a test for mutations in the gene that causes cystic fibrosis.
The sperm sample showed that there were no sperm. Can we still be treated?
Yes. In some cases, where there is no sperm in the semen, the sperm cells can taken directly from the testicles (TESA). This sperm can be used to fertilize oocytes with micro insemination (ICSI). If it is not possible to obtain sperm from the man, we recommend insemination with sperm from a sperm donor.
What if a man is sterilized and now wants a child?
Sterilization (vasectomy) of a man is carried out by a removing a small piece of both vas deferens (the tubes that carry sperm from the testes). The testes still produce sperm, but the sperm does not come out in the seminal fluid. In this situation, there are various options for treatment:
- Micro insemination (ICSI). Sperm for this procedure be obtained by sampling a little bit of tissue from the testicles (TESA). The method is effective, but it is is necessary to perform IVF og ICSI afterwards.
- Sterilization reversal, it means that an attempt is made to repair the severed ducts. The chance that there will be enough sperm in the semen after this treatment of this is about 50%.
- Insemination with sperm from a sperm donor. This treatment has good results, but the man is not the biological father.
Can you freeze a sperm sample for later use?
Yes. But sperm quality deteriorates whenever the sample is frozen. Freezing of semen samples can be used in rare cases where the husband, for example, are away when the sperm sample is needed.
Freezing of semen samples can also be used for storage of semen, if the man is facing treatment, for example with chemotherapy, which is known to harm sperm production significantly.
Want to know more?
If you want to understand more about male fertility examinations please call us or request a consultation.