Male infertility is present in up to half of all infertile couples. Therefore, it is very important that the male partner be evaluated early, prior to any female treatment(s). Donor sperm was once the only option for couples with moderate to severe male infertility.
With the advent of intracytoplasmic sperm injection ( ICSI ) a pregnancy can often be created with a single sperm. Using ICSI, a sperm is injected directly into the egg thus initiating fertilization. This means men with few, or in some cases no, sperm in the ejaculate can create genetically related children.
There may have been an increase in the incidence of male infertility over the last several years. We are sure that male infertility is being diagnosed more frequently due to increased public awareness of male infertility.
Male infertility may have several causes. One common cause is elevation of temperature in the testes. The scrotum functions to "heat" and "cool" the testes by moving them closer to or further away from the body. Anything that interferes with this function can cause male infertility. For example, tightly fitting clothes elevate testicular temperature by not allowing the scrotum to move away from the body. A varicocele is a blockage of the veins in the scrotum responsible for controlling temperature by supplying cooled or warmed blood.
Evaluation of male infertility should be conducted by a reproductive medicine laboratory. The andrologists at these facilities have extensive experience identifying subtle signs of male infertility. Sometimes insurance companies direct patients to commercial laboratories for the male infertility evaluation. We encourage patients to use a reproductive medicine lab even if they have to pay "out of pocket". "Missed" male infertility can lead to "futile" female treatments as pregnancy cannot occur without quality sperm.
Partners with male infertility are referred to one of our colleagues – a urologist specialized in male fertility. The evaluation typically includes taking a history, a physical examination and a repeat semen analysis. In some cases blood tests and ultrasound of the testes may be required.
In addition to a semen analysis, Center for Human Reproduction offers the Toluidine Blue Assay (TBA). TBA determines the percentage of sperm with quality DNA in a given semen sample.
What is the purpose of this test?
- To help provide answers to issues of unexplained infertility, miscarriages or failed cycles.
- To determine the most potentially successful course of treatment, (poor DNA integrity is associated with reduced IUI success).
- To provide a more detailed assessment of semen quality beyond the traditional semen analysis.
- To assess whether or not treatment interventions (i.e. varicocele repair, infectious disease treatment, etc.) were successful.
How does it work?
The test uses dye absorption to determine sperm quality; the less color absorbed the better the sperm's DNA quality.
How and where would I have this test done?
The test can be done right here in the Center for Human Reproduction’s Andrology Lab, just across the hall from our Reception area. To schedule an appointment please call (516) 562-1760. The Receptionist will review the instructions for the specimen collection with you. Please note, a written prescription from your doctor is required.
Our four full-time andrologists assess all parameters of
sperm and semen. In addition to providing high quality
sperm testing, our Andrology Laboratory’s refined methods
of sperm processing have contributed to high success rates
for our inseminations.