Diagnosis of male infertility – what tests should be performed?

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The diagnosis of male infertility is extremely important because it allows us to find out the cause of this problem and implement appropriate treatment. Many factors may affect male infertility, including civilization conditions, past diseases, addictions or an unhealthy lifestyle. What tests should be performed if infertility is suspected?

Male infertility – causes

Male infertility occurs when a man is unable to father a child with a fertile woman after about a year of regular intercourse without using contraception. It is assumed that about 15% of modern couples struggle with the problem of infertility, where in half of the cases the male is responsible for the infertility. The most frequently diagnosed causes of male infertility include:

1. hormonal disorders – as in the case of women, also in men, problems with the hormonal balance have a significant impact on fertility. Men with Kallman syndrome are sterile because the disease causes a secondary hormonal failure of the testicles. Pituitary diseases, such as pituitary underdevelopment, intracranial tumors, pituitary injuries or inflammatory damage also affect infertility;
2. Congenital or acquired defects of the genital organs – these are the most common causes of male infertility. Congenital or acquired defects include anorchism, i.e. the lack of testicles, monorchism, i.e. the lack of one testicle, testicular dysfunction, location of the testicles outside the scrotum, congenital defects of the penis, phimosis, too short frenulum or capillary. Acquired defects of the genital organs are usually a consequence of cancer of the testicle or testicular hydrocele;
3. systemic diseases – especially those diseases that reduce the quality of sperm. Such diseases include: thyroid diseases, diabetes, multiple sclerosis or childhood mumps with complications of orchitis;
4. unhealthy lifestyle – factors that can cause male infertility include: heavy smoking, alcohol abuse, a sedentary lifestyle, obesity, an unhealthy diet lacking minerals such as selenium and zinc;
5. environmental factors – pesticides, organic chemicals and contact with heavy metals have a significant impact on male infertility. Male infertility can also cause exposure to harmful radiation, including radiation and chemotherapy.

You can read more about the causes of male infertility here: Andrology and male infertility

Do you want to take care of the proper level of testosterone and support your fertility? Order Prostativ – YANGO dietary supplement. We also recommend fertility for men – the Panaseus dietary supplement, which contains, among others, maca root extract – a plant that supports fertility.

Diagnosis of male infertility – semen analysis

The basic examination in the diagnosis of male infertility is semen examination, otherwise known as a semogram and a spermiogram. The semen test is usually the first of the tests to be performed when you suspect male infertility. This test is performed to assess the quality of sperm, their number and activity. These results are compared with the standards presented in 2010 by the World Health Organization.

In semen analysis, the general parameters of semen are analyzed, i.e. the volume and viscosity of the ejaculate, its liquefaction time, its appearance, pH, total number of sperm, percentage of live and moving sperm, sperm cluster and its advancement level. If the test is extended, the sperm structure is additionally assessed and the proportion between normal and damaged sperm is assessed. The sperm may have a damaged head, twist, or insert.

The patient should be properly prepared for the semen analysis. 3-5 days before semen analysis, the patient should refrain from sexual activity, especially ejaculation. Moreover, the patient should not consume alcohol for the few days preceding the examination. Breaking the above rules may falsify the results. Semen is submitted for testing in sterile packaging.

It is possible to collect semen at home, but such material must be delivered to the laboratory within an hour. In infertility clinics, there are usually special rooms where the patient can relax in an intimate atmosphere. You wait about a week for the test result.

Home male fertility cassettes are now also available. The MAGNI-MAN test is one of the components of the Test kit for couples planning a child – home cassette tests. We also recommend the MAGNI MAN PRO male fertility test – home cassette test. The results of this type of test are available after just 15 minutes.

1. To support fertility, men can use special dietary supplements. We recommend, for example, Fertility for men Viridian available at a promotional price on Medonet Market.

Diagnostics of male infertility – MSOME-6600

MSOME-6600 is a test that allows you to judge whether the sperm is built properly and also to identify which sperm is the best. The name of the study is related to the fact that modern technology allows the observation of a live sperm at a magnification of over six thousand. The MSOME-6600 study is commissioned in specific cases, which are:

1. low percentage of sperm with normal structure, i.e. teratozoospermia found in semen analysis;
2. advanced age of a man;
3. finding a woman recurrent miscarriages.

The high microscopic magnification used in this study allows for an accurate, real-time evaluation of the morphology of the organelles of motile sperm. The assessment of the number, size and location of sperm allows to determine the presence of abnormalities in the sperm, which are selected for fertilization using the ICSI / IMSI method. The MSOME-66- test also allows you to combine the results of vacuole quality with the level of sperm DNA damage. The research showed that the sperm selected on the basis of the MSOME study improved the quality of the obtained embryo, influenced the speed of embryo development, and also increased the number of implantations and pregnancies.

How is a sperm built? Read: Sperm – what is it? Structure, life expectancy, male fertility

Diagnostics of male infertility – testicular biopsy

A special indication for testicular biopsy is azoospermia, i.e. the lack of sperm in male sperm. A biopsy is a procedure in which tissue is removed from the testicle or epididymis. Sperm cells are obtained from the collected tissue, which are then used for in vitro fertilization or insemination. There are two basic types of biopsy:

1. Closed needle biopsy – is a procedure performed under local anesthesia. There is a good chance of collecting sperm during a closed biopsy. The procedure involves puncturing the testicle through the skin with a needle. A closed biopsy takes about 15-30 minutes. There is no need to prepare for the procedure in any particular way;
2. open biopsy – is a procedure performed under general anesthesia. An open biopsy involves the incision of the testicular sheath and a section of the epididymis and other testicular regions. This type of procedure may take up to several dozen minutes. One week after the procedure, the patient should report for a follow-up visit.

More information on testicular biopsy can be found here: Testicular biopsy and diagnosis of male infertility

Diagnostics of male infertility – ultrasound examinations

If male infertility is suspected, ultrasound examinations of the testicles and scrotum are performed. Such examination allows for the diagnosis of varicocele, cysts and nodules. Testicular ultrasound is a non-invasive and painless examination for the patient. It allows the assessment of the structure and vascularization of the testicles, epididymides and cords. Ultrasound examination of the scrotum allows to diagnose pathological changes, such as cysts or varicose veins. The indications for an ultrasound of the testicles and scrotum are:

1. previous testicular injuries;
2. suspicion of a testicular tumor, varicocele or testicular hydrocele;
3. unpleasant symptoms within the genital organs, e.g. pain in the scrotum;
4. suspicion of an inguinal hernia, testicular abscess or hematoma, testicular underdevelopment or testicular torsion;
5. the presence of nodules located around the scrotum;
6. observation of the condition of the scrotum after surgery;
7. monitoring the progress of treatment.

Do you want to know more about the ultrasound of the testicles and scrotum? Read: Ultrasound of the testicles and scrotum in the diagnosis of infertility

Diagnosis of male infertility – SCD test

The SCD test is another test that should be performed during the diagnosis of male infertility. The specificity of the SCD test allows the detection of increased fragmentation of genetic material in sperm. The SCD test is also known as the sperm nuclear chromatin dispersion test. Sperm, which have the correct sperm chromatin at the same time through the DNA structure, are protected against harmful factors, such as oxidative stress. If there are any abnormalities in the sperm DNA, DNA integrity is usually degraded, resulting in fragmentation.

The SCD test is recommended as a complementary test to the diagnosis of male infertility. The indication for its performance are recurrent miscarriages of the partner. More than half of recurrent miscarriages are related to genetic defects of the fetus. They often result from the fragmentation of the sperm DNA.

More detailed information about the SCD test can be found here: SCD test in the diagnosis of male infertility

Diagnosing male infertility – HBA test

The HBA test is a test that complements the diagnosis of male infertility. The HBA test can determine what percentage of sperm is capable of fertilizing the egg. HBA from English is hyaluronian binding assay, i.e. a test of binding to hyaluronan. This examination is performed in the following cases:

1. extended semen analysis;
2. the need for additional diagnostics of male fertility disorders;
3. the occurrence of recurrent miscarriages in a partner;
4. obtaining incorrect results of SCD or MSOME-6600 tests;
5. idiopathic infertility, i.e. of unknown cause.

If you want to know more about the HBA test, be sure to read: HBA test for the diagnosis of male infertility.

Male infertility testing can also be done with a blood sample. Male infertility – AZF genetic test can be purchased at Medonet Market. The test is shipped, so we take a blood sample ourselves and send it to the laboratory. Results are available after 2-4 weeks.