The primary investigation for diagnosing male infertility. It is performed after 2-5 days of abstinence. A semen analysis, tests three basic sperm features:

A normal semen analysis, will lead the clinical investigation to the female partner. An abnormal sperm analysis, may be repeated after 15 days to three months. The entire process of sperm cell maturation takes around three months and normal fluctuations are observed (e.g. due to smoking, alcohol, medicine, stress, etc). It is likely that a sperm analysis may coincide with a “bad” spermatogenic cycle. If a second semen analysis diagnoses abnormal sperm parameters, then male contribution to the infertility cause is confirmed.

Intrauterine Insemination (IUI) is a fertility treatment that involves placing processed sperm, with optimized concentration and motility, directly into the uterus.

IUI can be performed with or without administrating fertility medications. Compared to timed sexual intercourse, IUI has 2 times higher pregnancy rate.

Intrauterine Insemination (IUI) offers infertility patients a simple, less invasive and less expensive option to enhance fertility.

Before offering IUI, women should have at least one patent fallopian tube as diagnosed during hysterosalpingography (radiographic contrast dye is injected into the uterus through the cervix and runs through the fallopian tubes).

Semen cryopreservation (commonly called sperm banking or sperm freezing) is a procedure to preserve sperm cells. Semen can be used successfully indefinitely after cryopreservation. For human sperm, the longest reported successful storage is 24 years.[1] It can be used for sperm donation where the recipient wants the treatment in a different time or place, or as a means of preserving fertility for men undergoing vasectomy or treatments that may compromise their fertility, such as chemotherapy, radiation therapy or surgery.

According to recent studies when a couple is not able to conceive over a period of 3 years, the chances to get pregnancy in the next year are less that 25%.

Sperm quality, inflammation (e.g. prostatitis, orchitis), genital injuries, congenital abnormalities (e.g. hypospadias), other pathological conditions (e.g. varicocele), or exposure at work in high temperature environments, may affect sperm quality.

A quite useful genetic test given in IVF clinics is FISH (Fluorescent In Situ Hybridisation). FISH analysis is a genetic test screening for genetic abnormalities providing information about the sperm chromosomes. It consists of sperm chromosome-specific DNA probes labeled with fluorochromes. FISH is an advanced technique that can now facilitate evaluation of sperm aneuploidy. The test could be be usefull in repeated failure attempts and/or poor quality embryos.

Infertility is not primarily a woman’s problem, as it is mistakenly believed. It is estimated that infertility for about half of couples is due to a male factor, either alone or in addition to female factors. So, if a couple suffers from infertility problems men should also be evaluated for infertility.

However, the routinely used in IVF clinics semen analysis testing appears to be inadequate in diagnosing the male factor infertility. In many cases couples dealing with conception problems have given a basic semen analysis testing result that is normal in terms of sperm concentration, motility and morphology. Yet the problem remains. In such cases genetic screening tests that can detect genetic abnormalities can be of great help, comprising diagnostic tools of great clinical value.

DNA fragmentation test is a genetic test that according to fertility doctors is associated with every fertility checkpoint and in contrast to conventional semen analysis it can discriminate between the sperm of fertile and infertile men. This test could explain the reason why you are not parents yet as high levels of DNA fragmentation can inhibit a successful pregnancy despite the type of fertility treatment provided. High levels of damaged DNA have been correlated to a series of things like infections, smoking, and exposure to environmental toxic chemicals.

TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval.

TESE is usually performed in the operating room with sedation, but can be performed in the or with local anesthesia alone. Testicular tissue is then checked under the microscope for the presence of sperm.

Patients usually cryopreserve sperm during this procedure for future IVF/ICSI.

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia (s/p vasectomy). Occasionally, TESA doesn’t provide enough tissue/sperm and an open testis biopsy is needed.