At GENNET City Fertility we offer many male investigations and tests, you will find details on some of the most common ones below. If you have any questions or would like to book any of these investigations/tests, please get in touch.
This is the basic test that gives an idea on testicular functions. The patient produces a semen sample by masturbation after a 2-4 day abstinence period. This is checked for a number of parameters including sperm count, motility and morphology.
Routine Semen Analysis assesses the concentration of the sperm, its motility (the percentage of moving sperm), the progression of sperm cells (the speed at which they are moving) and the percentage of normal sperm in the ejaculate. In addition we also check for anti-sperm antibodies which can be a contributing factor to subfertility. This will help us predict the chances of natural conception or highlight an underlying issue of subfertility. It’s recommended that two Semen Analyses are carried out to diagnose male factor subfertility. These should be two-three months apart.
This performed when the doctor thinks that chronic infection is the cause of subfertility. The semen sample is cultured to look for microbes and determine the appropriate antibiotic.
Sperm DNA Fragmentation Test
This test checks for the integrity of the genetic material (DNA) in sperm. Many lifestyle factors such as smoking, scrotal heat exposure and causes of male infertility such as varicocele and chronic infection lead to sperm DNA damage. High DNA fragmentation accounts for cases of unexplained infertility, recurrent miscarriage and failed IVF cycles.
Sperm DNA fragmentation tests look at the way that the DNA (the genetic code) is packed within sperm cells. The value of using sperm DNA fragmentation for all fertility patients has been debated. However, research suggests that men with high sperm DNA fragmentation would not benefit from simple treatments like IUI and should be therefore fast-tracked to IVF/ICSI.
Post Orgasmic Urine Analysis
A urine sample is checked after masturbation and orgasm to check for sperm in the bladder. Some causes of male infertility such as Diabetes, neurological diseases, some types of medicine cause semen to reflux backwards into the urinary bladder during ejaculation instead of coming out through the water pipe. This is called 'retrograde ejaculation', typically affected men present with dry or low volume ejaculate.
Male Reproductive Hormonal Profile
Men with a sperm count less than 10 million/ml may have a hormonal problem and need to have the following hormones checked: FSH, LH, Testosterone, Prolactin. Oestrogen is also checked in overweight men as they may have high levels of Oestrogen. Identifying such problems is important because some of these problems may respond to treatment thus restoring fertility, some may be a sign of an underlying serious health problem such as a brain lesion. Men who have low testosterone may need Testosterone replacement therapy after completing their fertility treatment for their general health and wellbeing.
Male Reproductive Genetic Profile
Karyotype: Men with a sperm count less than 10 million/ml may have an issue with their chromosomes which would require them to have the Karyotype test to make sure that their Karyotype is 46 XY. Identifying these conditions is important as some issues may have a negative impact on the health of the affected individual and their baby after successful IVF. Some of the karyotype issues require Pre-implantation genetic diagnosis (PGD) during the IVF cycle in order to prevent the congenital defects in the baby.
Y chromosome analysis: Men with a sperm count less than 5 million/ml may also have an issue with the AZF genes on the Y chromosome. This test may affect the decision of whether or not to perform surgical sperm retrieval.
Cystic fibrosis screen (CFTR gene tests): Mutations of the cystic fibrosis gene are involved in male infertility. Some causes of male infertility such as absence of the vas deferens are considered to be mild incomplete forms of cystic fibrosis disease. It is of utmost importance to also screen the female partner of the affected male for CFTR gene mutations. If the female partner is found to be a carrier of a CFTR gene mutation, Pre-implantation genetic diagnosis (PGD) is necessary to avoid having a child with the full blown picture of cystic fibrosis disease.
Male Genital Tract Imaging
Scrotal Ultrasound and duplex: This allows accurate visualisation of the testes to determine their size, blood flow, diagnose varicocele, obstruction and testicular cancer.
Any man with low sperm count should have a scrotal scan because the risk of Testicular cancer is 0.5–1% in infertile men Vs 0.001%- 0.01% in the general population.
In men with a history of undescended testes the risk is even higher (2–6%) even if they were brought down during childhood.
Trans-rectal Ultrasonography (TRUS): TRUS is needed if your doctor thinks that you have a blockage of the seminal ducts which run inside the prostate. This condition is called ejaculatory duct obstruction (EDO) and is a correctable cause of male infertility.