male Fertility

There are many causes of infertility that may impact on the male partner affecting their ability to father a child naturally. Galway Fertility Clinic offers a wide range of investigative tests which can identify any contributing factors in male infertility. The consultant reviews the medical history at the initial consultation and schedules tests as deemed appropriate.

The tests available include:

 

Semen Analysis

Galway Fertility clinic performs a detailed semen assessment on all male clients as part of their initial consultation.

The sperm sample is produced in either a discreet room within the clinic or at alternatively it may be produced at home, and delivered to us within an hour of production. These appointments are pre-arranged with the clinic.

Semen assessments are performed with reference to the World Health Organisation (WHO) guidelines. The sample is assessed for the following parameters:

  • Number of sperm present (density)
  • Motility (ability of the sperm to swim)
  • Morphology (size, shape and appearance) of the sperm 
  • Presence of Anti-Sperm Anti-Bodies
  • Other less significant factors such as volume, viscosity and present of white blood cells.

 

Where results fall outside the recommended (WHO) guidelines, they may be categorised as follows:

  • Low sperm number (oligozoospermia)
  • Reduced motility or survival of the sperm (asthenozoospermia)
  • Low numbers of normal shaped sperm (teratozoospermia)
  • No sperm present in the ejaculate (azoospermia)

Frequently a combination of these factors will be observed in the one sperm sample. For example oligoasthenoteratozoospermia – the number of sperm is low, their motility reduced and the morphology poor.

A repeat semen analysis test will be carried out if the initial results are poor, to rule out natural fluctuations in sperm quality, or if recent medication or illness are suspected as the cause of the poor findings. 

Where sperm quality has been identified as a possible cause of infertility, Galway Fertility Clinic can provide such treatments as IUI, IVF or ICSI to address this issue. Alternatively Donor Sperm may also be presented as an option.

Furthermore, some men can improve their sperm quality by making lifestyle improvements. It may take 3 months before such improvements are seen in a repeat semen analysis. The embryology team are happy to discuss and advise you on this.

Further information on lifestyle improvements is available from our professional partners at:

 

Anti-sperm antibodies

The human body produces antibodies when the immune system requires.

In 4% of men, the immune system may produce antibodies directed against sperm, called anti-sperm antibodies (ASAB). The antibody production can be as a result of a testicular injury or trauma or testicular surgery, however in most cases the cause is unknown.

Anti-Sperm Antibodies can cause the sperm to adhere or “stick” to each other, reducing their motility and their ability to reach the egg, for fertilisation to occur.

Galway Fertility Clinic routinely tests all semen samples for the presence of Anti-Sperm Antibodies, the results of which determines the best treatment plan for you.

 

Sperm DNA Fragmentation Testing

The sperm’s primary function is to deliver a complete copy of the male’s genetic information (DNA) to the female’s egg.  The DNA within the sperm in tightly packed to protect it, until it reaches the egg.

However, for some men this “packaging” is not as complete as it should be and the DNA is susceptible to damage on its journey from testis to the fallopian tube

The degree of DNA damage can have an effect on the sperm’s ability to fertilise the egg and on the development of the subsequent embryo.  This damage is not visible in a semen analysis and specialised testing is required. A sample of the ejaculate is frozen and shipped to specialised private testing laboratories where the degree of fragmentation is measured.

The Sperm DNA Fragmentation test is offered as part of your initial assessment and is used as a guide to determining treatment. In cases where high levels of DNA fragmentation are detected IVF and/ or ICSI is the recommended treatment (rather than ovulation induction).  In cases where very high levels of DNA fragmentation are found, then a testicular biopsy for sperm may be advised.

PICSI dishes can be used with the ICSI procedure to assist the selection of sperm with less DNA fragmentation.

A repeat DNA fragmentation test may be recommended if the male embarks on healthy lifestyle changes (for example stopping smoking, improving diet etc.), all of which can contribute to fragmentation level changes. 

Galway Fertility Clinic has partnered with two specialised laboratories that can offer this test:

 

Hormone Profile

Certain male hormones have a role in the development and maturation of sperm. A simple blood test is used to assess the levels of follicle stimulating hormone (FSH), testosterone, prolactin & luteinising hormone.

Where severely low sperm counts are found, this may be due to a hormone imbalance, although this is rare in men. In such cases, the consultant may decide to do a hormone profile on the male partner, to determine the cause for the low sperm count.

 

Karyotyping and Genetic screening

Chromosomes and Genetic Screening

Some chromosomal and genetic conditions are associated with male infertility.  Where poor results are found during the semen analysis, karyotyping and cystic fibrosis screening may need to be carried out.

 

Karyotyping

Karyotyping involves analysing a blood sample for the number and appearance of the chromosomes. Where abnormal chromosome results are identified, this may contribute to fertility problems.

 

Cystic Fibrosis (CF)

Cystic Fibrosis is Ireland’s most common genetically inherited disease and approximately 1 in 19 people are carriers of the CF gene. Cystic Fibrosis screening involves examining the blood DNA for the presence of the gene. This test is normally performed when there is no sperm present in the sample for analysis or when there is a family history of CF reported. In such cases the female partner is also screened for CF. If both partners are CF carriers, there is a 1 in 4 chance of the baby being born with Cystic Fibrosis disease.  Clients may be referred for genetic counselling to discuss the impact of the findings on their treatment options.