A topic that is rarely spoken about, male infertility accounts for up to 50% of all infertilities, and impacts approximately 7% of men.
But what is male infertility, and how deep does it go into explaining possible fertility problems?
What is male infertility?
Almost a third of fertility problems are related to male factor. A man’s fertility will rely on the quantity and quality of his sperm and it is estimated that approximately one in 20 men in Australia will have a decreased sperm concentration. Male fertility can be affected by problems with sperm production or physical issues. Studies have revealed that approximately two thirds of men with fertility problems will have a sperm production issue which could range from low sperm production to no sperm being produced at all, to poor motility, functionally impaired antibody production or morphologically abnormal sperm being produced.
Due to the fact that the examination of the male is relatively non-invasive, this is often the first test performed when investigating the cause of infertility.
At Fertility First, our highly experienced andrology scientists will assess male fertility through a semen analysis and sperm antibody testing to measure the key parameters of semen known to impact fertility. All male fertility tests in our NATA accredited laboratory follow the guidelines and assessments set out by the World Health Organisation (WHO).
How can Fertility First help with male infertility?
Fertility First offers patients the option of the Halosperm assay which is used to assess the fertility potential of sperm by determining the percentage of sperm that contain fragmented and damaged DNA.
The Halosperm assay provides invaluable information about the quality of the DNA inside the sperm’s chromosomes and helps to provide clinical diagnosis and the management of male infertility. Find more information on Halosperm below.
When choosing a fertility clinic in Sydney, it’s important to consider the success rates, as well as the quality of care.
How do I make an appointment?
It is possible to make an appointment for a semen analysis, Halosperm assay, and HBA testing using the same semen sample if there is a sufficient volume.
Due to the length of time required to perform the assays, we offer patients appointments throughout the week. It is recommended that you ejaculate 2 days prior to the test and appointments must be made at least 2 days in advance due to the preparation required. Semen tests cannot be performed if you have abstained for more than 7 days.
Fertility appointments can be made by calling Fertility First on (02) 9586 3311 or filling out the contact form below.
Please note that the reagents required to perform the assays are very expensive and must be prepared the day prior to your test. A cancellation fee of $450 will be applied if your appointment is cancelled with less than 24 hours notice to the laboratory. Here is a full list of Fertility First costs.
Male Infertility Frequently Asked Questions
Fertility First offers patients the option of the Halosperm assay which is used to assess the fertility potential of sperm by determining the percentage of sperm that contain fragmented and damaged DNA. The Halosperm assay provides invaluable information about the quality of the DNA inside the sperm’s chromosomes and helps to provide clinical diagnosis and the management of male infertility.
The Halosperm assay determines the percentage of sperm that contain fragmented DNA in the sperm’s chromosomes. These chromosomes make up the male half of any potential pregnancy or child. Fragmented DNA in sperm is DNA which is ‘broken’ in one or many areas. As DNA is the genetic material which is passed on to a child from its biological parents, ‘broken’ sections can have adverse effects on resulting embryos and can result in genetic defects in the child.
In addition, published research has extensively demonstrated that the higher the percentage of sperm with DNA fragmentation, the lower the chance of pregnancy occurring naturally or after fertility treatment and the higher the risk of miscarriage (up to 4 times higher risk) if a pregnancy does occur.
Upon entering the female reproductive tract, the sperm will undergo a maturation process which will allow them to successfully fertilise the egg. Just like people who reach puberty at different times, so do sperm. If a sperm matures too early, it will not reach the egg and it will die before it has a chance to fertilise the egg.
Sperm that mature too late will not be capable of fertilisation, even if they come into contact with the egg. When the mature sperm reaches the egg, it will bind to the “protective shell” or the eggs’ zona pellucida and through a series of chemical reactions and physical force it will be able to penetrate and fertilise the egg. The protective granuloma cells surrounding the egg produce a protein called Hyaluronan and the mature, functional sperm cells will express receptors for this protein and bind to it during the fertilisation process.
The Hyaluronan Binding Assay (HBA test) will allow the andrology scientist to quantify the percentage of the sperm that can bind to this protein, revealing the percentage of a man’s sperm that is mature. This test can help determine which treatment to apply to a patient. Binding scores that are low are generally recommended for ICSI in conjunction with a viscous medium that allows the embryologist to choose a sperm with normal functionality known as SpermSlow.
When the Halosperm assay is performed in conjunction with a standard semen analysis, an overall picture can be obtained of the likelihood of the sperm being a factor in a couple’s fertility problems. A standard semen analysis is only useful for determining the transport aspects of sperm i.e. how many there are, how well they move and whether they are the correct shape. The Halosperm assay provides invaluable information about the quality of the DNA inside the sperm and therefore what the sperm can do when it gets inside the egg.
An abnormal test result does not mean that you cannot have children. It simply enables us to determine the best form of fertility treatment for you. Lifestyle changes and antioxidant therapies may be recommended.
Our studies have shown that more than 75% of patients who make changes to their lifestyle and take the recommended dietary supplements have a reduction in DNA fragmentation after approximately 2 months. A significant number of these patients go on to conceive naturally and the miscarriage rate is dramatically reduced (less than 5%).
Antibodies are proteins that will attach to a specific substance or organism which the body recognises as “foreign”. When the body detects a foreign organisms, white blood cells will secrete antibodies into the blood stream which will then attach to the “foreigner”. Some antibodies will destroy the foreigner while others will act as beacons to direct the body’s other defence mechanisms to the scene. Sperm will not normally be recognised as part of the body and can therefore be considered as foreign, thus initiating this immune response.
In a man, the organs that produce and store the sperm (the testes and the epididymis) are protected environments and as a result the sperm are not usually detected or destroyed by the body’s defence mechanisms. However, after an infection, physical damage or an operation such as a vasectomy, the protective layer can become less effective, the body will detect the “foreign” sperm and antibodies will be produced.
Both women and men can generate antisperm antibodies (ASABs) and can cause fertility problems in one or more of the following ways:
- They can cause clumping of sperm in the semen.
- Cause interference with the passage of sperm through the cervical mucus.
- Directly prevent fertilisation from occurring once the sperm meets the egg.
Once a patient has had a clinically positive ASABs test, it is usually recommended that the best option is through ICSI to maximise their chances of fertilisation.
Various studies have shown that patients with clinically significant levels of ASABs can still achieve a healthy pregnancy through ICSI to the point that success rates are unaffected by the presence or concentration of the antibodies.