The causes of infertility can equally affect a woman and a man. Therefore, diagnostics at InviMed clinics always include both partners. The brochure you are reading concerns the male part of InviMed Patients. According to data from the World Health Organization (WHO), the so-called the male factor in infertility accounts for about 45% of cases.
Men’s affairs
Women go to the gynecologist and men go … for a beer. This stereotype of thinking still functions in our society. It is still the case that if a couple tries to have children, the woman is first diagnosed and treated. And when all fails, only a man is referred for research. At the InviMed Clinic, we decided to change this way of proceeding.
The problem of fertility, regardless of the side on which it lies – male or female – concerns the couple. And that is why the couple should be investigated and treated. The diagnosis of men is much less complicated than that of women, and a few basic tests are enough to assess health and fertility. On the other hand, treatment for a man is often lengthy and time-consuming – the time that the couple usually misses the most.
Contact with an andrologist is also an opportunity to talk about difficult topics bothering men. Topics that they would not dare to tackle anywhere else because they are too embarrassing.
A woman goes to a gynecologist and a man … to an andrologist – because her semen parameters are lowered, because she has ailments that should be examined or simply because she cares about herself and her health.
Dr. Robert Jarema, MD, surgeon – FEBU urologist specialist,
andrology consultant at the InviMed Clinic in Warsaw
Semen analysis
The first step towards assessing your partner’s fertility is to do a sperm test. In InviMed clinics, they can be performed on the basis of a referral from a doctor, as well as without a referral. However, the patient must contact the clinic reception in advance and book a convenient date. Preparation for semen analysis consists of sexual abstinence for 3 to 5 days.
We expect 3 or 4 business days for the result. The basic test describes semen parameters such as: liquefaction time, volume, viscosity, ejaculate appearance, pH, percentage of live and motile sperm, number of sperm per 1 ml of semen, total number of sperm in the ejaculate, presence and possibly the degree of sperm agglutination.
In addition, we perform a sperm morphology test, i.e. the percentage of correctly built sperm and the percentage of various structural defects related to the sperm head, insert and twine, the percentage of spermatogenesis cells present in the ejaculate, the number of leukocytes in 1 ml of semen and the number of epithelial cells and erythrocytes.
In the extended test, we get an additional parameter, which is the HOS test (hypoosmotic test), which measures the integrity of sperm membranes, giving us information about the proper functionality and viability of the sperm.
Another specialist test performed at InviMed is the SCSA test. It allows you to assess the quality of sperm and the ability of sperm to fertilize. The basic parameter assessed using the test is sperm DNA fragmentation, which may be one of the main reasons for the decline in male fertility (in vivo and in vitro).
The high level of sperm DNA fragmentation may determine:
• with reduced ability to fertilize;
• about abnormalities in the division of the zygote and early development of the embryo;
• about more frequent early and spontaneous miscarriages;
• with an increased risk of genome damage;
• with an increased risk of transmitting genetic defects to their offspring.
Each semen test result contains, in addition to the results of a given Patient, the WHO standards. On their basis, everyone can initially determine whether the results are within the standards or if they show any deviations. In any case, specialists andrologists and urologists are waiting for you at InviMed clinics, who will interpret the results in detail and, if necessary, will prescribe the appropriate treatment.
TREATMENT
The treatment process, in the case of male fertility disorders, is adapted to the cause, using: hormonal drugs (hypogonadotrophic hypogonadism, hormonal disorders), antibiotics (inflammation in the sperm exit ducts), surgical procedures (obstruction of the sperm ducts, varicocele) and assisted reproductive techniques (IVF / ICSI, IVF / IMSI).
IVF / ICSI – in some cases, in the ivf procedure, micromanipulation is performed – ICSI. It is the introduction of a sperm into the cytoplasm of the ovum. The indications for the use of this technique are usually abnormal sperm test results, which do not ensure fertilization of the cell in vitro. It is also used when previous attempts at in vitro fertilization have been unsuccessful.
IMSI (Intracytoplasmic Morphologically – Selected Sperm Injection) – is an intracytoplasmic injection of a morphologically selected sperm. IMSI is a highly specialized laboratory procedure that, thanks to the use of modern equipment and digital imaging techniques, allows embryologists to select sperm with the correct structure.
A clinical trial conducted by the IARIHR in Rome and published on July 7, 2008 in The Times found that couples with high levels of oligoasthenoteratozoospermia, a male factor of infertility, have an IMSI pregnancy rate that is 12,7% higher than that of by the ICSI method, and the implantation rate (implantation of the embryo into the uterine cavity) is higher by 6%.
IMSI is also an opportunity for couples who have previously had miscarriages. For patients who experienced 2 or more failed IVF attempts, 16,9% more pregnancies and 20,1% fewer miscarriages could be achieved by using IMSI instead of ICSI.
Other studies, carried out at the clinic in Paris, prove that even with the defragmentation of sperm DNA above 30%, thanks to the IMSI method, it is still possible to obtain implantation and then give birth to a child, which was not possible with the ICSI method.
Before the use of IMSI, the so-called a preliminary test, called MSOME, which is a test of sperm morphology at a magnification of 8000 times (!). If the result shows a normal sperm count of less than 8%, an in vitro IMSI procedure is recommended.
Such a wide spectrum of tests that can be performed in InviMed clinics gives a chance to detect many abnormalities in semen. It allows you to discover the causes of infertility and apply the most appropriate method of treatment. Thanks to detailed diagnostics, specialists are able to assess the patient’s chances of having their own child and, if necessary, decide on the use of assisted reproductive techniques.
With the current state of knowledge, there is little we can do to improve the quality of sperm, but with highly specialized equipment, we can find and use those that give a chance for paternity.
More on the website www.invimed.pl in the Men’s Matters tab