Overview

Fertility Treatments for Men

Fertility Treatments for Men

Getting an accurate, complete diagnosis helps couples dealing with infertility find the best treatment method. University of Utah Health's Andrology Lab provides both common and more advanced infertility testing procedures that other facilities don't provide.

Infertility treatment is also one of the fastest advancing fields in medical science. As an academic medical center, University of Utah Health’s andrology lab is the leader in bringing our patients the latest advancements in infertility testing.

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Diagnostic Testing Procedures

Semen Analysis

stained semen analysis

Semen analysis is the most efficient and inexpensive way to study male fertility. It’s usually the starting point for a male infertility evaluation. Semen analysis looks at:

  • sperm concentration (how many sperm are in each milliliter of semen),
  • a motile sperm count (how well your sperm move and swim),
  • and study of sperm morphology (shape).

Your sperm count is a measurement of how much sperm moves towards the egg—in other words, how much sperm is available to fertilize an egg. Lower sperm concentration, along with how well your sperm move and swim (also called sperm motility), can also affect your motile sperm count. The shape of your sperm (morphology) is also important since sperm that are shaped incorrectly have a have a harder time fertilizing eggs.

A normal semen sample is usually made of 35 percent normal, correctly shaped sperm. The other 65 percent of sperm are often abnormally shaped or abnormal. A smaller percentage of normal sperm could cause infertility problems.

Sperm Penetration Assay (Hamster Egg Penetration Test)

hamster egg penetration test

The hamster egg penetration test (HEPT) (also known as the sperm penetration assay) is the most accurate test that predicts whether your sperm will be able to fertilize an egg. It can also predict whether lab techniques can improve your sperm’s ability to fertilize an egg. During a hamster egg penetration test, a lab analyst will evaluate your sperm samples using techniques that are similar to the techniques used in IVF. The only difference is that a doctor uses eggs from a hamster. A lab analyst will chemically treat hamster eggs to see if human sperm can penetrate them.

The prepared sperm are incubated with 15 to 20 chemically treated eggs. If your sperm is working how it should, it will be able to penetrating the eggs. The lab analyst will then count how many eggs were penetrated and calculate a percentage.

If fewer than 50 percent of the hamster eggs are penetrated, this means your sperm can’t fertilize eggs as well as normal sperm can. If more than 50 percent of the hamster eggs are penetrated, your sperm should also be able to penetrate human eggs.

Anti-Sperm Antibody Test

All men have barriers that hide sperm from their body’s immune system. These barriers help keep your body from identifying your sperm as foreign, 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 damage sperm’s ability to move and/or agglutinate (clump with other cells).

Women may also produce anti-sperm antibodies. We can test for antibodies by evaluating seminal fluid, semen, and the serum from the woman. You should have an anti-sperm antibody evaluation if:

  • your sperm motility is low when you’re getting ready for a vasectomy reversal,
  • you have a higher amount of agglutination,
  • or if your sperm may not be working correctly.

Women should be tested for anti-sperm antibodies if a sperm cervical mucus interaction assay test suggests a problem.

Strict Criteria (Kruger) Morphology

strict criteria morphology

The term strict criteria morphology analysis refers to a specific technique that looks at the shape of your sperm. The sperm morphology (shape) can predict the ability of your sperm to fertilize an egg when combined with other fertility treatments. The test carefully evaluates the sperm head, tail, mid-piece, and tail attachment.

Retrograde Semen Analysis

We may recommend a retrograde semen analysis for men with a low sperm count. (An initial semen analysis will show if you have a low sperm count). Retrograde ejaculation is when sperm ends up in your bladder. If you have retrograde ejaculation, sperm will be in your urine after you have sex.

Many men with retrograde ejaculation have had an earlier surgery or medical condition that makes them more likely to develop retrograde ejaculation. Many things can make you more likely to develop retrograde ejaculation. These may include the following:

  • testicular cancer surgery (RPLND)
  • transurethral surgery of the prostate
  • childhood bladder surgery
  • diabetes
  • MS
  • spinal cord injury

Sperm Chromatin Integrity Test (SCIT)

SCIT tests analyze the quality of your chromatin and whether there are any breaks in your DNA strands. Chromatin is a bundle of genetic material inside your cells and includes DNA, RNA, and prortein. Both of these things have been shown to affect an embryo’s quality.

Lab analysists usually find DNA breaks during chromatin remodeling. But if your DNA strands are broken, this damage will be repaired during the late stages of spermatogenesis. If the damage is not repaired, DNA breaks inside your sperm may affect your sperm’s ability to fertilize an egg. DNA breaks can also affect the quality of embryos.

The SCIT sample is divided into two portions. One portion will be used to evaluate DNA damage. The second portion will be tested density gradient centrifugation. In the final part of the test, our lab analysists will see if DNA in your sperm are damaged.