SA, Morphology Test, Specialized Tests, Advanced Tests - CASA, DNA Fragmentation, Sperm Bank, Sperm Freezing, PESA & TESA
Semen Analysis (SA)
- Semen is the fluid containing sperms and other substances that is released during ejaculation.
- Semen Analysis test analyzes the health and viability of man's semen.
- Doctors will often conduct two or three separate sperm analyses to get a good idea of sperm’s health. The tests should be conducted at least seven days apart and over the course of two to three months.
- Sperm counts can vary on a daily basis. Taking an average of the sperm samples can give the most conclusive result.
- Macroscopic Examination involves observation of volume, pH, colour, odor, liquefication of the semen. The presence of important sugar - fructose is also detected.
- Microscopic Examination is the most important observation revealing the status of the male fertility potential. It involves following observation -
- Sperm Count - The sperm count and total sperm count of the semen is determined. To watch video - Click Here
- Total Motility at 37 degree - The total percent of motile sperms in the semen is determined.
- Sperms with progressive motility (Grade IV) - The percent strongest best sperms which swim fast in a straight line is determined.
- Sperms with non-linear motility (Grade III) - The percent sperms with forward motility but tend to travel in a curved or crooked motion is determined.
- Sperms with non-progressive motility (Grade II) - The percent sperms which do not move forward despite the fact that they move their tails is determined.
- Sperms with no motility (Grade I) - The percent immotile sperms which fail to move at all is determined.
- Sperm Morphology - The percent sperms having normal morphology is determined.
- Other cells - The presence of abnormal cells like Pus cells, RBC's, Spermatids are determined.
Sperm Morphology Test
- When it is indicated in the semen analysis that high number of sperms are abnormal (teratozoospermia) in the semen, this test is advised.
- This is a computer assisted test which analyse each and every morphological features of the sperms and gives vital information about the abnormal sperms. The results of this test are also very helpful to determine the proper line of treatment of infertility.
- The various types of sperm head, neck and tail defects are analyzed. Multiple anamoly index (MAI), Teratozoospermia index (TZI) and Sperm Deformity index (SDI) are determined which gives the information about the degree of morphological abnormality in the sperms of the semen sample.
Specialized Sperm Tests
There are various special tests which are performed depending upon the semen analysis results -
- Leucoscreen Test - Normal semen contains pus cells or leucocytes. But if present in more number 'Leucoscreen Test' is performed to confirm if there is any infection of the male reproductive tract.
- Semen Culture and Sensitivity Test - When the semen sample is infected, this test is performed to detect the infectious bacterial species as well as the range of antibiotics sensitivity for the isolated bacterial species is determined. Depending upon the results the infection can be treated effectively.
- HOS (Hypo-osmotic swelling) Test - When all the sperms in the semen are immotile, this test is performed to detect whether the immotile sperms are live or dead. If the test comes to be positive, the couple can be advised to go for ICSI - IVF treatment cycle.
- Sperm Agglutination / Antisperm- Antibody Test - When there is agglutination (head-head or head-tail) in the semen sample, presence of sperm antibody is indicated in the sample. This is confirmed by Antisperm-Antibody Test through which the antibody type in the sample is detected. The presence of sperm antibody in the semen affect the male infertility significantly.
- Sperm Aggregation Test - When there is clumping of sperms in the sample, it is further analyzed by this test. The degree of aggregation is observed which gives information useful for the treatment. Abnormal aggregation in the sample can be seen due to hyperactivation of the sperm may be due to increase in temperature.
- Sperm- mucus interaction / Post coital test (PCT) - This test detects the presence of highly motile sperms present in the women's cervical mucus within 2-3 hours of coitus. Satisfactory results indicates a healthy coitus. Unsatisfactory results may indicate the inability of the sperm to survive the cervical mucus barrier and needs to be treated.
Intrauterine Insemination (IUI)
- Intrauterine Insemination (IUI) is a form of assisted conception in which the semen is washed and processed to obtain highly motile sperms with fertilizable potential.
- These sperms are directly placed into your uterus (womb) by means of a catheter during the time of ovulation.
- This procedure is often combined with fertility drugs to increase the chances of conceiving.
- 1st IUI is generally performed on day 12- day 14, before the ovulation. On next day a transvaginal ultrasonography on empty bladder is done to confirm the rupture of the follicle (i.e. ovulation), and 2nd IUI is done only after ultrasonography confirmation of ovulation.
Computer Assisted Semen Analysis (CASA)
- CASA is a fully automated system to analyze the semen parameters. It gives more detailed information about the sperm motility velocity kinectics. This system is generally used in research labs but we are proud to have this unit with us for using it exclusively for our male factor infertility patients.
- The manual person to person error is fully eradicated by using this system. Reproducible results can be obtained using this system which gives 100% authentic results.
Sperm DNA Fragmentation Test
- The most advanced test using an automated system is available at our centre. When the exact cause of infertility is utmost undetecable and in cases of repeated abortions due to unknown reason, Sperm DNA Fragmentation test can reveal surprising results.
- Semen analysis and other methods are based on the physical appearance of the sperms. But to achieve a normal pregnancy the most important component is the DNA from both the parents. By this test the DNA integrity of the sperms can be directly analysed which is a boon for many infertile couples.
- Based on the results of this test, further line of treatment can be planned without wasting any time.
- Semen sample can be freezed in liquid nitrogen for a long peroid of time.
- It is used for freezing of semen in stimulated IVF cycles. Husband’s semen are freezed 4-5 days prior to oocyte retrieval so that there is no panic if husband fails to produce semen on demand on day of OR.
- Semen samples are frozen for IUI uses if husband is not available at the day of IUI.
- It is useful for certain couples whose husbands are working outstation for very longer peroids.
- Sperm freezing can be useful in cancer patients undergoing chemotherapy cycles.
- We are associated with an established sperm bank.
- Donor sperm samples are tested for various infectious disease like HBAgs, HIV, etc. Only 100% surity disease free excellent sperm samples are selected and used for sperm banking.
- Series of donor sperm samples with required blood groups, height, color of skin & hairs are available with us.
- Donor sperm samples can be used in simple treatment like IUI or in IVF also. Sperm banl is a boon for patients of azoospermia and others.
Obstructive Azoospermia -TESA, PESA, MESE
- These are procedure done for the azoospermic male patients (no sperms in the semen) or aspermia (unable to produce semen) or indicated to detect the presence of sperms in the testes.
- Sperm are aspirated with a needle from the testicle or from the vas deferens (a structure right next to the testicle that also contains sperm) under local anesthesia.
- There are various procedures depending upon the area from which the sperms are aspirated -
- PESA - Percutaneous Epididymal Sperm Aspiration
- TESA - Testicular Sperm Aspiration
- If sperms are retrieved they can be used in ICSI – IMSI treatment.