Apr 11

Male Infertility

Male Infertility

The shape of a spermatozoon determines the fertilizing potential. It also determines their performance ability and also their motility. It also determines if the genetic material is intact and that it will enter into the egg when fertilization takes place. Male infertility is caused by sperm, abnormalities that arise when the sperm is being produced or even because of some functional problems or the combination of some other factors.

When a pregnancy fails to occur under natural situations, there is a need to see if the fertilization can really occur. It therefore becomes necessary to actually take the egg as well as the sperm so that they can be put together using the IVF process. Before the IVF test, the sperm is studied into detail and functional and quantitative tests are done. This helps one to note any deficiencies that maybe present with the profile of the sperm.

Analysis of semen

 SemenAnalysis-300x225A sample of the semen is actually analyzed normal shape of the sperm, the percentage of the normal sperm as well as the volume and the concentration of the sperm within. When one of the parameters is not met, it means there is a problem. When many abnormalities are detected, there is a very great likelihood that the male infertility problem is caused by that.

Criteria morphology (Kruger) strict Criteria

Criteria morphology is used when the analysis is being done. Microscopic analysis is done. This includes the measurement of the head and tail size of the sperm. In fertile men, 90% of the sperm is abnormal whine the strict criteria is applied.

The swim up test

The swim up test entails a procedure where sperms are allowed to swim until a given duration of time. This is done in a vial designated for the testing. The sperm number that is able to make it to the layer on top co-relates with sperm ability to fertilize.

Detection of antibody that is anti-sperm

If in case sperms gets into contact with circulation of blood due to surgery or injury, , the sperm may be identified as being foreign agents and antibodies may be produced to deal with it. The proteins from the antibodies may get attached to sperm thus fertilization becomes impossible.

Sperm chromosomal abnormalities

Chromosomalabnormalities-300x150Male abnormality may be caused by abnormalities that are chromosomal. These may be structural or numerical. In numerical cases, the sperm has less or more of the chromosomes which should be 23 in numbers. The structural circumstances may have a rearrangement of the chromosomes in a balanced way. Such a person may produce unbalanced sperm or even normal ones. If a gamete which is unbalanced is able to get an egg fertile, the embryo will be chromosomally abnormal and may have losses or excess genetic material. Such abnormalities may lead to embryo death, a miscarriage or a live birth with the infant having many medical issues.

Screening chromosomes in sperms using Aneuploidy

In this process, the FISH technique is used. This is where some DNA pieces are bound in some chromosome regions and then analyzed. Different dyes are used so as to label them. When a fluorescent kind of microscope is used, one is able to visualize the signals for each chromosome that is available. This is how aneuploidy of the chromosomes is performed. When a single signal is seen, it shows a monososmy which is normal. Two show disomy while three indicate trisomy of some specific chromosomes. 500 sperms are evaluated at a time as a way of determining aneuploidy percentage. Fertile men have a rate of 2-4% while infertile ones haveup to 27%.

Apoptosis (fragmentation of DNA in sperm)

Apoptosis may be defined as procedure that is natural where cell death is programmed. There are steps that are involved in apoptosis. This includes fragmentation of DNA, condensation of chromatin, shrinkage of cells and then the entire cell fragments. In some instances, some sperms that have damaged DNA may not be eliminated and may cause fertilization. This is in cases where ICSI is done. The increase in sperm levels during apoptosis especially when the IVF procedure is applied correlate to the impaired embryo morphology especially in the early stages when the culture doesn’t progress to blastocyst stage and a decrease in the rates of pregnancy.

Apoptosis-300x260

Infertile men tend to have apoptotic spermatozoa on a higher percentage as compared to the fertile males. If the index of apoptotic spermatozoa is greater than 40%, probability of IUI is greatly decreased. The chances of a spontaneous miscarriage are also increased and in IVF and ICSI, failure of pregnancy, embryo arrest and failure to fertilize may occur.

The TUNEL method or the trabsferase-mediated Dutp is able to detect apoptosis in the spermatozoa whereby DNA strands actually break with a molecule of fluorescent. 500 sperms are required for this procedure.

The quality analysis of semen may not be able to give specific information and cannot be able to predict the numerical aberrations of chromosomes within the spermatozoa. It can’t be treated as an attribute that is sole in cases of reproduction that is assisted. When chromosomal aneuploidy and apoptosis are determined, the selectioncriteria are improved to a great extent. This makes it very easy for suitable semen to be actually chosen and leading to a greater success rate.

Aspiration procedure of sperm

In most cases when sperm is not available within ejaculate, it may be in the epididymis or within the testicles. These reasons may be the cause of absent sperm:

  • Blockage within the system thus the sperm cannot reach the world so as to fertilize even though it is produced.

  • Fewer sperm production in the testes.

  • When there is obstructive azoospermia, it is possible to retrieve the sperm through surgery called Micro epidydymal sperm aspiration (MESA). If sperm retrieval in the EPIDYDYMIS is not successful, the same is done to the testicle using the TESE procedure.

  • Where there is none obstructive azoospermia, TESE is performed and sperm is retrieved. When sperm is retrieved by the use of these procedures, it is always of a quality that is poorer as compared to sperm that is ejaculated. If a patient has to go through TESE or MESA, then technological advancements such as ICSI are used so as to make fertilization possible.

Our Prices

In Vitro Fertilisation (IVF) Cycle with own gametes from 1300€

Gametes Donation from 2600€

×