Male Fertility Tests: Ottawa Fertility Clinic
Tests to Check Male Fertility
About 1/3 of couples that experience infertility do so as a result of male-factor infertility. Surprisingly, another 1/3 of couples that experience infertility have a combination of both male and female factors contributing to infertility. However, the testing for male fertility is often very basic and not very thorough.
A basic sperm analysis allows to check for 4 important variables:
1. Sperm Progressive Motility: this evaluates the percentage of sperm cells that exhibit healthy movement in a forward direction, and a low progressive sperm motility is diagnosed as asthenozoospermia.
2. Sperm Concentration: this evaluates for the number of sperm cells estimated to be contained per mL of ejaculate. Low sperm concentration is diagnosed as oligozoospermia.
3. Normal Sperm Morphology: this test evaluates to see what percentage of sperm cells appear to look like healthy looking sperm cells (i.e. don't have two heads, have the correct sized cell, tail is attached correctly, and more). Low normal sperm morphology is called teratozoospermia.
4. Sperm Viability: this important test checks for what percentage of sperm cells is actually alive. In some cases, Males have lots of healthy looking sperm cells, but they are not actually alive. This is diagnosed as necrospermia.
These 4 basic tests allow to determine if there are obvious causes for the infertility a couple is experiencing. It is important to check for all four.
Advanced Sperm Function Tests
An additional test which is gaining traction in fertility clinics is Sperm DNA Fragmentation testing. This is different from a genetic screen. The DNA fragmentation tests checks to see what percent of the DNA in sperm cells appears to have damage of "hairline fractures."
This is a vital test, especially for couples that have experienced recurrent miscarriage. Elevated sperm DNA fragmentation rates increase the risk of IVF failure and elevate the miscarriage risk in couples expecting within the first trimester.
Treatments for Male Infertility
The treatment of male-factor infertility with naturopathic treatments is crucial, as the main treatment options are centre around improving overall health, reducing oxidative stress and inflammation, supporting optimal hormone function, and supporting healthy blood flow to the testes.
Treatments you should strongly consider for improving male fertility and improving sperm health parameters include:
1. Intravenous vitamin infusion therapy: this helps to deliver high dose antioxidants not possible with oral supplementation to improve sperm motility and normal sperm morphology. Antioxidants are also a crucial component for the treatment of elevated sperm DNA fragmentation rates.
2. Fertility Acupuncture: has been shown to help balance hormone levels, improve sperm concentration, and improve overall health.
3. Diet & Lifestyle Counselling: has been shown to significantly improve male fertility. This goes in-depth to the research where commonly considered healthy foods which can actually be harmful are discussed, and optimal dietary and lifestyle choices are discussed.
4. Clinical nutrition: helps to provide the necessary nutrients in high therapeutic doses to improve sperm concentration, testosterone production, sperm motility and improve normal sperm morphology.
Valuable Blood Tests for Male Fertility
In addition to the sperm analyses mentioned above there are certain blood tests which can provide valuable information regarding male fertility parameters. These tests can usually be done any time and it is not necessary to be fasting when going for them.
Follicle Stimulating Hormone (FSH): is a hormone produced by the pituitary gland. This hormone signals the testes to produce sperm cells and if sperm concentration is low, this test can provide us with a more detailed insight of what may be causing the issue. If the FSH level is elevated, it means the issue is usually with the testes and if it is low, it means the issue is with the pituitary gland. Different diseases can affect the two differently. For example, elevated stress, in some cases a benign tumour, or certain medications can result in suppressed FSH levels from the pituitary gland, as well as a history of concussions.
Luteinizing Hormone (LH): is another hormone produced by the pituitary gland and its role is to signal the production of testosterone from the tested. Testosterone plays a valuable role in supporting sperm cell production and low testosterone can aversely affect male fertility.
Free Testosterone: is the testosterone that is available in the blood and not bound to any proteins (such as sex-hormone binding globulin). This is a more accurate test for testosterone levels rather than “total testosterone” as it accounts for what is actually available. In some cases, total testosterone may be find but is bound to other proteins in the blood making it unavailable for the body to use.
Bioavailable Testosterone: accounts for free testosterone plus the testosterone bound weakly to an abundant protein known as albumin in the blood. Testosterone bound to albumin is easily dissociated and used when needed by the body.
Estradiol (E2): the potent form of estrogen and if this is elevate it may affect fertility negatively. It is important to assess this hormone if there are clinical signs that it may be elevated. Particularly in patients with a lot of adipose (fat) tissue, this hormone increases as the adipose cells actively convert testosterone to estradiol, thereby decreasing testosterone levels and increasing estrogen levels.
Screening for STIs: additional testing for screening for these infections can help to treat infections early and prior to fertility treatments if possible. This is important as certain infections can negatively affect sperm health and fertility.
Prolactin: is a hormone produced by the pituitary gland. Production of prolactin can be increased as a normal reaction to high levels of stress, but may also be elevated in the presence of a tumour on the pituitary gland. The increased production of prolactin suppresses the production of testosterone in the body by decreasing production of LH and FSH from the pituitary gland (which are needed to signal testosterone production in the testes).
This information is presented for educational and informative purposes only. This is not a replacement or substitute for medical advice from your fertility doctor or physician. If you have any questions or concerns regarding fertility drugs, please follow-up with your fertility