Andrology Services
Male Factor Treatment
“Male factor” patients are those whose male partners have poor sperm counts, low sperm motility, improperly shaped sperm, or antibodies against their own sperm. You may want to see an Andrologist (a specialist in male infertility) before beginning IVF treatment.
Causes of Male Infertility
- Male infertility is prevalent. Half of infertile couples have a male element, and 20% of men are subfertile.
- Male-factor infertility accounts for 30% of IVF operations. Infertility surprises most males.
- The testis serves two purposes. The first is to generate testosterone, which gives men sex desire, erections, powerful muscles, and a sense of well-being. "Virility" encompasses these.
- The second purpose of the testis is to create millions of sperms daily in its 150 meters of tiny tubes. Most infertile men only have this process to blame for low sperm production.
- Most infertile men produce few sperms with poor motility and irregular shapes. In such males, only a few regularly shaped motile sperm will swim up the woman's fallopian tube to the egg and may not fertilize it.
Why does this problem develop?
- Most cases are inherited. These men lack the genetic information needed to produce normal sperm. We researched this with Monash University. Some infertile men lack genetic information on the Y (male) chromosome or other chromosomal abnormalities.
- More study is needed because most of the genes are unknown. With that understanding, men's sperm-boosting treatments are likely. IVF requires far less normal sperm than nature does, offering optimism.
- One-third of infertile men have a probable cause, such as: The vas deferens can stop sperm from leaving the testis. Vasectomy, injuries, surgery, and sexually transmitted illnesses are common causes.
- After vasectomy, men can develop sperm antibodies. Infertility is often caused by antibodies that hinder sperm from swimming or adhering to the egg.
- Only specialized labs like PFRC can screen fresh sperm for such antibodies. Chemotherapy, radiation, and other treatments can destroy the testis.
- Diabetes, MS, and prostate surgery can cause erection and ejaculation issues in males. In such cases, IVF can be done with sperm.
- Brain pituitary hormone deficiencies rarely cause low sperm counts. Hormone injections treat it; therefore, detection is crucial.
- In conclusion, many men's infertility causes are unknown but treatable. These facts necessitate a detailed investigation of all infertile guys.
Artificial insemination
To increase the likelihood of pregnancy, artificial insemination entails inserting the male partner’s semen into the female partner’s uterus.
Indications for AI include
- Mechanical issues with sexual activity, such as failure to erect, structural issues with the penis after trauma, etc. A normal semen analysis is required. Using frozen stored semen if the male spouse is gone for an extended period.
- Contact allergy to semen. If there is a serious issue with the semen analysis, this is not the preferred procedure. To ensure that insemination takes place on the day of ovulation, the menstrual cycles of the female partner are monitored.
- This is accomplished by spotting the LH spike in urine or blood. Drug stimulation is not employed in cases where a woman does not have regular menstrual cycles.
- In case the male partner's semen is determined to be faulty, a scrotal doppler is performed after a blood test to evaluate hormones and semen.
Semen Collection
- Masturbation into a tiny sterile container is the standard method for collecting sperm specimens. Anywhere within 45 minutes of collection, whether in the PFRC Collection room or elsewhere, is acceptable.
- You and your wife can visit any of our four dedicated collection rooms. The setting is ideal for you to generate a quality semen sample. Please call our office if you have special needs and need to make other arrangements.
Screening
- Screening tests, such as semen culture, Hepatitis B, Hepatitis C, and HIV (AIDS) testing, must be performed before storing sperm to reduce the likelihood of virus infection. Your specialist may have already done those; if not, we may arrange them.
Costs
- Information on semen freezing and storage costs is available from PFRC. PFRC may provide costs for semen analysis, freezing, and six-month storage upon request.
Testicular Biopsy
- Using testicular biopsy, sperm can be extracted. This technique is usually done to unblock the sperm transport mechanism.
- Thus, no sperm are found in the ejaculate, but the testis may produce many. This condition can be inherited or caused by infection or vasectomy scarring and obstructing the testis' tiny tubules.
- Fine needle biopsy is done in some patients. The testis and skin are numbed by local anesthetic above it. After inserting a fine needle into the testis, a small bit of tissue (about half a grain of rice) or sperm is removed.
- After examining the biopsy sample's fine tubes, the embryologist takes sperm for microinjection. A fifteen-minute tiny needle biopsy is performed. Microinjection cycles can employ leftover sperm. A biopsy can be repeated. The microinjection method with testicular sperm has a 55% clinical pregnancy rate per cycle.
- This process done with local anesthesia might only be able to be used in some places.
- A testicular biopsy may also be done on men whose testes are so badly affected that they don't make much sperm or have any in their ejaculate. In this case, a bigger testis biopsy is done while the person is under a general anesthetic.
- In 50% of cases, enough sperm can be made by carefully processing the biopsy tissue to find the small "islands" of sperm production that continue even though other parts of the testis are damaged.
- If there are no sperm, the pair must decide whether to throw away the eggs, freeze the eggs, or use sperm from a donor.
The range of tests include
Reproductive Endocrinology
Tests for pregnancy include Progesterone, LH, FSH, Prolactin, Testosterone, HCG, and HCG. Our menu of tests for reproductive hormones is always being looked at and expanded.
Serology
Tests for pregnancy include Progesterone, LH, FSH, Prolactin, Testosterone, HCG, and HCG. Our menu of tests for reproductive hormones is always being looked at and expanded.
Semen Analysis
Tests for pregnancy include Progesterone, LH, FSH, Prolactin, Testosterone, HCG, and HCG. Our menu of tests for reproductive hormones is always being looked at and expanded.
CASA(Computer Aided Semen Analysis)
Tests for pregnancy include Progesterone, LH, FSH, Prolactin, Testosterone, HCG, and HCG. Our menu of tests for reproductive hormones is always being looked at and expanded.
Sperm Antibody Testing
A crucial first line of inquiry using serum and spermatozoa immunobead testing for direct and indirect assessments. The lab offers a referral service for sperm antibody evaluations from other significant diagnostic facilities nearby.
Specialized Andrology Procedures
A crucial first line of inquiry using serum and spermatozoa immunobead testing for direct and indirect assessments. The lab offers a referral service for sperm antibody evaluations from other significant diagnostic facilities nearby.
Sperm DNA fragmentation
The physical severing of one or both DNA strands in the sperm chromosomes is known as sperm DNA fragmentation. To identify males at risk of failing to start a pregnancy, a DNA test is performed to determine the DNA Integrity. It could be treated if a lifestyle factor like smoking, drinking, or varicocele brought it on.
Scrotal Doppler
The physical severing of one or both DNA strands in the sperm chromosomes is known as sperm DNA fragmentation. To identify males at risk of failing to start a pregnancy, a DNA test is performed to determine the DNA Integrity. It could be treated if a lifestyle factor like smoking, drinking, or varicocele brought it on.
Y Chromosome Deletion Test
After Klinefelter’s Syndrome (XXY), Y chromosomal deletions cause the greatest male infertility. Y chromosomal deletions affect 15% of men with sperm counts under 5 million per ml. Australian IVF facilities use Monash Reproductive Pathology and Genetics for Y chromosome testing. European norms demand 10ml of blood for our multiplex PCR test. Y chromosomal deletions are significant. First, a positive test will diagnose the man’s issue, which may help couples with long-term infertility overcome stress, blame, and guilt. Second, ICSI transmits Y chromosomal deletions to male offspring, which may cause sterility in males as they mature. Genetic counseling before ART is advised if the male spouse has a Y chromosomal loss.
Semen Cryopreservation
After Klinefelter’s Syndrome (XXY), Y chromosomal deletions cause the greatest male infertility. Y chromosomal deletions affect 15% of men with sperm counts under 5 million per ml. Australian IVF facilities use Monash Reproductive Pathology and Genetics for Y chromosome testing. European norms demand 10ml of blood for our multiplex PCR test. Y chromosomal deletions are significant. First, a positive test will diagnose the man’s issue, which may help couples with long-term infertility overcome stress, blame, and guilt. Second, ICSI transmits Y chromosomal deletions to male offspring, which may cause sterility in males as they mature. Genetic counseling before ART is advised if the male spouse has a Y chromosomal loss.
Newer technology in male infertility
- When no sperms are detected in semen analysis, despite pellet preparation, this is known as azoospermia. Some of these people have biopsies of their testicles performed for medical reasons.
- Once solely performed in a single location, subsequent research has demonstrated that a single-site biopsy may overlook specific foci of sperm production even when the majority of the testes lack spermatogenesis.
- To pinpoint the precise locations of the glands responsible for sperm production, we've begun conducting testicular mapping, which involves collecting biopsies from various spots.
- With the development of assisted reproduction methods, even a small number of sperm can be used for ICSI or IMSI. We have begun using an operating microscope to perform testicular mapping at Prashanth Fertility Centre.
- There is less risk of testicular injuries, and the incisions are less invasive. This method will allow for a more comprehensive mapping of the testis, increasing the likelihood that we will locate these spermatogenesis hotspots.