Before planning your pregnancy or your previous attempts to achieve a pregnancy have been unsuccessful then it is important to keep in mind that 40% of infertility causes in couples developed because of male infertility, according to the latest data even up to 50%. Thus it is recommended to undergo Complex Sperm Test which is including: Standard Sperm test (motility, morphology and MAR test), Sperm Function test (amount of mature sperm cells) and DNA fragmentation test (sperm count without DNA damages).
Sperm test (or Semen Analysis)
This test is recommended to investigate man’s semen and quality of sperm cells it contains. In cases when the couple have not used contraception during 1 year and the pregnancy has not occurred then the first analysis which is recommended is a Sperm Test (Standard Semen Analysis), to examine general quality of sperm. Analysis is detecting concentration of sperm cells in 1 millilitre and in total ejaculated fluid, motility and morphology. As well as MAR test which is detecting presence of antisperm antibodies (ensuring body’s immune response to sperm cells) on the surface of sperm cell.
Sperm function test – In the case if indicators after sperm test are within normal range, but unfortunately the pregnancy has not occurred then it is recommended to undergo a Sperm Function test.
Standard sperm test is using visual evaluation of sperm. Unfortunately good test results do not exclude other invisible defects as for example – immature sperm cells. Only mature sperm cells have an ability to fertilize an egg successfully. Egg membrane contains hyaluronic acid – it is required for sperm cells to successfully attach to an egg, dissolve it and further to fertilize it.
Egg membrane contains hyaluronic acid for the reason that sperm cells would attach to an egg and are dissolving it, as well as to fertilize it successfully. Only heads of mature sperm cell have attachment receptors. Immature sperm cells have increased DNA fragmentation, aneuploidy (changes in chromosome number) and immature cytoplasm.
DNA fragmentation test is recommended for patients with:
- Unexplained Infertility
- Interrupted embryo development
- Poor blastocyst development
- Multiple unsuccessful treatment cycles
- Pregnancy interruption in short period of time (miscarriages)
- Varicocele etc.
In some cases Sperm DNA fragmentation may be reduced by changing way of life and habits, also using antioxidants in the nutrition which will liquidate the free radicals as well as will treat the diseases causing the DNA fragmentation. When general sperm parameters such as – motility, concentration, morphology all have been within the normal range, sperm may still be the cause of unsuccessful results after artificial insemination procedure. Sperm DNA fragmentation is expressed as a rupture of DNA strand in both or just one DNA helix. If the rupture affects genes which are vital for embryo and implantation development then during some stage the embryo may not survive.
Possible DNA fragmentation causes:
- Oxidative stress
- Drug use
- Environmental pollution (heavy metal, air pollution)
- Elevated testicular temperature etc.
In order to exclude out of the list of possible infertility causes various health disorders or diseases (prostate inflammation, inflammation, varicocele, cryptorchidism and others) which may affect quality of sperm then urologist’s/andrologist’s counselling is highly recommended.