Providing an accurate, complete diagnosis increases the chances of finding an appropriate treatment for couples dealing with infertility. University of Utah Health Care’s Andrology lab provides a comprehensive menu of infertility testing procedures as well as offering less common procedures not readily available at other facilities. The treatment of infertility is one of the fastest advancing fields in medical science and as part of the region’s only academic medical center, the University of Utah Andrology lab is the leader in bringing our patients the latest advancements in infertility testing.
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Diagnostic Testing Procedures
The Semen Analysis is the most efficient and economical method of evaluating male fertility. It is usually the "starting point" for the evaluation of male infertility. The evaluation of the sperm includes: sperm concentration, progressively motile sperm count and sperm morphology (shape).
Decreases in sperm concentration and sperm motility affect the motile sperm count, which reflects the ability to get a high enough concentration of sperm to the egg site to complete fertilization. Sperm morphology is important because it too reflects upon the ability of the sperm to fertilize an egg. A normal semen sample may consist of 35% normal, correctly shaped sperm and the remaining 65% may be abnormally shaped or abnormal sperm. A smaller percentage of normal sperm could result in reduced fertility.
Once the analysis is performed, the results are interpreted and mailed/faxed to the referring health care provider in seven to ten calendar days.
The Sperm Penetration Assay (SPA, also known as the Hamster Egg Penetration Test (HEPT) is the most accurate test in predicting fertilizing ability, and can also predict the ability of laboratory techniques to improve sperm fertilizing ability. The sperm samples are evaluated in much the same manner as with in vitro fertilization (IVF), except that the eggs (chemically treated to allow normal human sperm to penetrate them) are obtained from a hamster. The prepared sperm are incubated with 15-20 chemically treated eggs. If functionally competent the human sperm can complete the first steps of fertilization including the penetration of the egg, but nothing happens beyond that point. The penetrated eggs are counted and a percentage is calculated.When test results are compared; if less than 50% of the eggs are penetrated in the non-stimulated sperm, there is a decreased ability to fertilize. Depending on the actual value, various treatment options may be suggested. A score higher than 50% indicates that the sperm should have an ability to fertilize.
In males, barriers exist to "hide" sperm from the body’s immune system. This is to keep the body from identifying the sperm as foreign, classifying it as dangerous and producing a defense against it. When these barriers break down the body produces anti-sperm antibodies. If these antibodies attach themselves to sperm they cause severely diminished motility and/or agglutination. Females may also produce anti-sperm antibodies. The presence of antibodies is evaluated by testing seminal fluid, semen and the serum from the woman. There should be an anti-sperm antibody evaluation if: in preparation of a vasectomy reversal, sperm motility is diminished, there is an increase of agglutination observed or if sperm viability is in question. Females should be evaluated if a sperm cervical mucus interaction assay test necessitates it.
The term strict criteria morphology analysis refers to a specific grading technique that evaluates the shape of the sperm. The sperm morphology has been shown to be predictive of the fertilizing ability of the sperm when combined with other measures of fertility. The test includes a very stringent evaluation of the sperm head, tail, mid-piece and tail attachment.
A retrograde semen analysis is indicated for patients with a low volume and a diminished sperm count in the initial semen analysis or possible medical history implications. Predisposing factors include testicular cancer surgery (RPLND), transurethral surgery of the prostate, or childhood bladder surgery. Medical conditions such as diabetes, MS, or spinal cord injury may also predispose an individual to retrograde ejaculation.
Retrograde ejaculation is the ejaculation of sperm into the bladder. Urine released following sexual activity will contain sperm in men who undergo retrograde ejaculation.
SCIT assess chromatin integrity and DNA strand breaks, which have been shown to correlate with embryo quality. DNA breaks are normally found during chromatin remodeling, however, this damage is repaired during the late stages of spermatogenesis. Retention of sperm DNA breaks may affect fertilization ability and embryo quality.
Douglas T. Carrell, Ph.D.Locations
|Andrology & IVF Laboratories||(801) 581-3740|
Specialties: Andrology, Reproductive Endocrinology & Infertility, In Vitro Fertilization