Male Fertility Testing: What to Expect?
Probably you are utterly embarrassed when you hear the pronunciation of these 10 letters –– ‘Infertility’. Being a man and being infertile sounds confusing and frustrating. But not only sounds. You feel both confusion and frustration. It is not ok to hide behind closed doors. It is not ok to be ashamed of that. And it is not ok that you have to deal with this by yourself…and it is a good thing you are not. Here, the infertility testing takes place.
Evaluation of male infertility includes a full medical history, physical examination, Hormone Analysis and Semen Analysis. Additionally, your doctor may recommend you such tests as scrotal ultrasonography, Transrectal Ultrasound (TRUS), Magnetic Resonance Imaging (MRI), vasography and seminal vesiculography. Wondering what to expect?
1. Medical History, Physical Exam and Blood Tests
Infertility testing includes not only Female Factor Infertility. You will be also involved in the testing for Male Factor Infertility. Everything starts with your medical history and male physical exam. After that, some blood work will be done by your doctor for evaluating your hormone levels. The basic male fertility blood test your doctor will do checks your testosterone levels. It is called the Male Testosterone Fertility Blood Test. Testosterone is the essential hormone which is ‘RESPONSIBLE’ for the normal sperm count. A low testosterone level can reduce your sperm count, making it more difficult to conceive.
2. Semen Analysis
After that Semen Analysis [Sperm Test] is done. Yes, your tiny ‘dudes’ will be also accurately investigated. The Semen Analysis represents the basic information about what is going on ‘INSIDE’ your tiny ‘dudes’ and how they feel. It shows whether or not you have your sperm in your semen, gives the information about your its appearance and shape (morphology), movement (motility), semen consistency (viscosity), the presence or absence of white blood cells, red blood cells, or immature sperm.
3. Bacterial Culture Test
Bacterial infection of the male genital tract can also be the cause of infertility. If your doctor suspects that you may have the bacterial infection, you will undergo the bacterial culture test to identify the bacteria which caused the infection and to start the Treatment.
The test is performed with a small portion of a semen sample for determining whether there is an infection of the prostate or not. It is possible to have such an infection and not even be aware of it. The most common general infections are staphylococcus, streptococcus, and enterococcus, which are usually easily treated with antibiotic medications.
4. Sperm DNA Fragmentation Test
Sperm DNA Fragmentation Test might be performed to measure the amount of damaged DNA in your sperm sample. Sperm DNA fragmentation refers to the amount of damage seen in sperm DNA. Essentially, calculating what percentage of the sperm has broken DNA structures will be done by the specialist. If your doctor suggests you undergo this test, you shouldn’t feel ashamed. Your tiny dudes [sperm cells] are very small, yet they need to carry massive amounts of genetic information to the oocyte. The oocyte is the largest cell and similarly intricate. The sperm is the smallest cell, but also one of the most complex. With so much DNA structures getting packed into a tiny sperm cell, it turns out not everything arrives intact as intended.
5. Blood Tests for HIV and Hepatitis
Some of your tests will be ‘SYNCHRONIZED’ in time. Your semen tests and sperm will be done in parallel with blood tests. That means that additional blood draws are inevitable procedures. You have to expect such blood tests as tests for HIV and Hepatitis before you undergo any Fertility Treatment.
6. Male Fertility Blood Test for Genetic Disorders
Your doctor may recommend you do the fertility blood test for genetic disorders. Genetic Tests are performed to evaluate whether the sperm chromosome abnormalities cause infertility. This is done to verify if there is something wrong and what exactly is wrong.
For example, severe male factor infertility can be caused by a condition called Klinefelter Syndrome, which is caused by an extra X chromosome in sperm cells. Another genetic disorder that causes male factor infertility is a mutation in the gene that causes Cystic Fibrosis. These men lack the tube that carries sperm from testicles to the penis. In this case, sperm can be collected from the testicles and used to fertilize an oocyte through ICSI. Genetic Testing for infertility is done to test for these issues.
This test should be also done if you have a genetic disorder, you have several physical features that indicate you may have a genetic disorder (for example, small testicles or the vas deferens cannot be felt during routine physical examination), your Semen Analysis test shows that you have a very low sperm count, your fiancée has had several miscarriages.
7. Anti–Sperm Antibody Tests may be performed to
evaluate whether your body produces antibodies that bind sperm, affecting its motility and/or viability. High levels of anti–sperm antibodies can interfere with the natural conception.
8. Diabetes Blood Test
Diabetes can cause sperm damage, erectile dysfunction, retrograde ejaculation, and hypogonadism. If you have not been diagnosed with diabetes, but you display some of the symptoms, your doctor will send you for a blood test to see if you have it.
WHAT OTHER TESTS SHOULD I EXPECT?
The male reproductive system imaging is the next phase of the male infertility evaluation. And there are three main imaging modalities used for investigation of the male reproductive system are ultrasound, MRI and invasive techniques such as venography and vasography.
Ultrasound remains the best method for investigation of the male reproductive system as it is non–invasive technique. Ultrasound is also able to define many of the abnormalities relevant to male infertility. Ultrasound is almost always the initial imaging investigation in male infertility. The ultrasound scans can show testicular morphology, patency of the efferent ducts and prostatic anomalies. Erectile dysfunction may also be assessed via this technique.
MRI is useful in problem–solving cases, and the invasive techniques are reserved for therapeutic intervention in previously defined abnormalities.
9. Scrotal Ultrasound
Scrotal ultrasound is an essential imaging modality in diagnosing testicular and scrotal pathology, as it accurately shows the anatomical details of the testicle and surrounding structures and evaluates vascular perfusion in real time. Scrotal ultrasound is excellent for initial evaluation of the scrotum and can directly demonstrate abnormalities within the testis and the peritesticular structures, such as varicoceles and epididymal abnormalities. It is a perfect technique for visualizing secondary changes caused by distal genital duct obstruction.
This test uses high–frequency sound waves to produce the accurate images inside your body. A scrotal ultrasound shows your doctor if there is a varicocele or other problems in the testicles and supporting structures.
10. Transrectal Ultrasound
If your doctor suspects obstructive azoospermia (the absence of both spermatozoa (your tiny dudes) and spermatogenic cells in semen), the issues with the seminal vesicles, or the issues with prostate, this ultrasound will be performed. It is the modality of choice in diagnosing abnormalities implicated in the cause of obstructive azoospermia, which is associated with low ejaculate volume.
Transrectal ultrasound is non–invasive imaging technique which enables high–resolution imaging of the prostate, seminal vesicles and vas deferens. It shows if there are any abnormalities in the seminal vesicles, ejaculatory duct and the status of the prostate.
CONCLUSION:
The diagnostic workup of male infertility includes a thorough medical and reproductive history, physical examination, and Semen Analysis, followed by imaging. The main role of imaging is the identification of the causes of infertility, such as congenital anomalies and disorders that obstruct sperm transport and may be correctable. Scrotal ultrasonography is the most common initially performed noninvasive examination used to image the male reproductive system, including the testes and extratesticular structures such as the epididymis. If these tests fail to identify the reason, you may undergo additional invasive and non–invasive tests.