Tests to Diagnose Infertility in Men

It is important to note that 3 out to 10 times, infertility may be related to an underlying issue with the male partner, while 4 out to 10 times it may be associated with the female partner. Sometimes it is a mix of conditions associated with both partners. And sometimes it is just unexplained.

At CReATe West Fertility, the team of fertility specialists will diagnose the underlying cause(s) of your infertility, which may be related to age, sperm production and motility, medical history of STDs, exposure to environmental conditions, hormonal imbalances or complications due to surgery or injury.

What are the causes of infertility in men?

Sperm maturity and development can be impacted by various conditions. Some of the common issues causing infertility in men are as follows:

Sperm Disorders

In many cases, infertility may be related to disorders associated with the sperm- the sperm may not be fully grown, may be oddly shaped, may have low motility or the count may be low or may not be there at all. In addition to these complications which may be genetic, lifestyle issues such as smoking, drinking alcohol or medication use may also impact the sperm count leading to infertility. Long-term sickness, childhood infections, or hormonal imbalances can also lead to sperm disorders. Damage or blockage in the reproductive system may also lead to no or low sperm count.

Varicoceles

These are swollen veins in the scrotum. Varicoceles are a common cause of infertility as they harm sperm growth by blocking proper drainage by causing blood to flow back into your scrotum from your belly thereby increasing the temperature of the scrotum affecting sperm count.

Retrograde Ejaculation

In this complication, semen can go back into the bladder and not into the vagina causing infertility. Retrograde ejaculation can be caused by surgery, medications, or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or “dry” ejaculation.

Immunologic Infertility

This condition of infertility is due to an autoimmune disorder. The body starts to make antibodies against the sperm. This may be due to an injury, surgery, or infection. Due to this autoimmune reaction from the body, the sperm quality is impacted leading to infertility.

Obstruction

In some cases the tubes carrying the sperm may be blocked, leading to infertility. This can happen due to infections, surgery (vasectomy), swelling, or congenital defects.

Hormones

Hormone production is controlled by the pituitary gland. Low levels of male hormones may impact the production, count, quality, shape, and motility of the sperm, causing infertility.

Medication

Certain medications can impact sperm production, count, and motility. Medications associated with cancer, kidney disease, arthritis, depression, and high blood pressure have been known to impact fertility.

How is infertility in men diagnosed? What tests are recommended by doctors to diagnose infertility in men?

Male infertility diagnosis can be complicated and hence, your fertility specialist will first begin the process with just general physical examination, medical history evaluation, hormone, and semen analysis.

1. General physical examination with medical history assessment

Your fertility specialist will examine your genitals and enquire about any genetic and inherited medical conditions along with infections, injuries, or surgeries that may lead to infertility. They may also ask questions about your sexual development and habits.

2. Hormone analysis

The pituitary gland and the hypothalamus play a major role in sperm production through hormone production. Any imbalance may cause abnormalities and lead to infertility. Your fertility specialist may recommend testing your testosterone levels, along with a few other hormones such as thyroid-stimulating hormone (TSH) or prolactin.

3. Semen analysis and sperm kinetics

You will be requested to provide a sample of your semen for the analysis. The laboratory will assess the sample for sperm count, shape (morphology), movement (motility) and infections if any.

a. Computer Assisted Semen Analysis (CASA)

CReATe West Fertility has a well-equipped lab for sperm kinetics. Supported by Computer Assisted Semen Analysis (CASA), the test can detect sperm motion, kinetics, and qualities or fertilization – sperm count, pH, concentration, and shape.

This test is covered under Ontario Health Insurance Plan (OHIP) and may need an appointment to schedule the same. In certain cases, your sample may also be frozen and sent over to CReATe Fertility Toronto for diagnostic assistance.

b. Anti-Sperm Antibody (ASA) Test

This test detects the presence of certain antibodies (proteins) in the sperm sample that may be fighting against the body’s sperm. If a high number of sperm antibodies come into contact with a man’s sperm, it may be hard for the sperm to fertilize an egg. Sperm can cause an antibody or immune system response in a man’s or a woman’s body.

Infertility resulting from this complication is called immunological infertility. This test is covered under Ontario Health Insurance Plan (OHIP) and may need an appointment to schedule the same. In certain cases, your sample may also be frozen and sent over to CReATe Fertility Toronto for diagnostic assistance.

c. Sperm DNA Fragmentation Index (DFI) Test

Sperm DNA damage can be associated with male infertility and pregnancy loss/miscarriage. Sperm DNA Fragmentation Index (DFI) is a valuable test to predict pregnancy success and loss. The test analyses the structure and the integrity of the sperm DNA to assess the male factor.

This test is NOT covered under Ontario Health Insurance Plan (OHIP) and may need an appointment to schedule the same. In certain cases, your sample may also be frozen and sent over to CReATe Fertility Toronto for diagnostic assistance.

d. Fluorescent In-Situ Hybridization (FISH)

Fluorescence in situ hybridization (FISH) provides researchers with a way to visualize and map the genetic material in an individual’s cells (sperm), including specific genes or portions of genes. This may be used for understanding a variety of chromosomal abnormalities and other genetic mutations in the sperm. This test helps ascertain the male factor for infertility, especially if there are repeated failures in IVF, ICSI, and miscarriages.

Based on your test results, your fertility specialist will provide a recommended approach to assisted reproduction options.