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Sperm and Semen Testing and Evaluation




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Those who do make it into the uterus are greeted by white blood cells that see the sperm as invaders and attack them. These percen swim like crazy to try to find eprcent Fallopian tube while avoiding white cells. Finding the fallopian tube is like finding a needle in a haystack. There, the sperm must survive long enough to meet and fertilize the egg. The more healthy swimmers you send in, the better your chances are that one of them will find the egg. However, it is very hard to precisely correlate pwrcent count to chances of pregnancy. A man ssperm has a low sperm spsrm with healthy sperm may have a better monthly chance of conceiving than a man who has a higher sperm count but the sperm are unhealthy.

Several large scale studies have analyzed the relationship between semen quality and how long it took a couple to get pregnant. Here are the highlights: Typically, sperm cells are counted and categorized by both speed and direction of movement. To understand the challenge, imagine you were to take a swat at a beehive and record how many bees flew away in a straight line and how many hovered around. Because analyzing sperm motility is difficult, there is a lot of variation from lab bormal lab and from report to report. No matter the counting method, the semen sample 30 percent sperm normal to norjal collected. First, is making a high quality sample. Abstain from ejaculation 30 percent sperm normal before producing a semen sample for analysis.

While collecting the sample, avoid lotions, lubricants or oils as percentt are toxic to sperm and can cause results. Make sure you collect all of the ejaculate, especially the first part; that has most of the sperm. Finally, the motility analysis should be done soon. Sperm motility decreases the longer it is outside your body, so be sure the sample is analyzed within hours of collection. Of those cells, the technician categorizes them into: Some believe that judging these subcategories by sight is too subjective, but some extremely well-trained technicians can categorize by sight quite well.

Since the technician counts cells, the number counted for each category represents the percentage of sperm that fall into each category. The technician counts another cells on another slide and makes sure the numbers make sense before reporting to the doctor or patient. There are some drawbacks to this method, however. One is the obvious human error. A technician counts by looking at the cells under a microscope in a field of view. Sometimes, they can be mistaken. Only well-trained technicians end up being precise[2], [3]. Inexperienced ones can make a lot of mistakes.

Because the work is mentally challenging, even well-trained technicians can get tired when straining their eyes to count sperm. To reduce sampling error, a technician can count more cells, but often if they do, the operator fatigue becomes a bigger factor. A camera recording of a microscopic view can help in having multiple eyes look over a sample, and confirm that the numbers are correct. Additionally, operator fatigue and subjectivity can be reduced by simply having a computer do the counting. CASA comes in multiple brands and packages and, depending on what kind your doctor has, is able to measure a bunch of different things about the semen samples.

When looking at motile cells, CASA offers a distinct advantage over manual methods[5],[6]. IgM antibodies, because of their large molecular size, are rarely seen in semen. Several studies had implied that the conventional sperm parameters count, motility and morphology as measured on a routine semen analysis had no bearing on success when ICSI was used. Many couples pursued egg donation after failed IVF attempts because the husband's semen parameters were relatively normal and yet conception hadn't occurred. Some of these same couples were still unable to conceive even with the "better quality" donor eggs leaving both the doctors and the couples frustrated and perplexed.

Some couples then went on to use both egg donors and surrogates thinking it was both an egg quality and implantation issue, again without success. The only commonality was the husband's sperm. Ina relatively new concept was introduced to clinical practice; sperm quality was dependent on the amount of damage to the sperm DNA or DNA fragmentation. Simply put, DNA is arranged in a double helix or ladder configuration with side rails and rungs. If the rungs are broken, then the ladder is unsteady and won't function properly. What has recently been shown in several studies is very interesting and in some ways unexpected.

Sperm DNA fragmentation has little or nothing to do with the parameters that we measure on the routine semen analysis. It has little to do with the shape of the sperm or whether the sperm are moving. It is a completely independent variable.

Men sprrm otherwise normal semen analyses can have a high degree of DNA damage and men with what was called very poor sperm quality can have very little DNA damage. More importantly what has also been demonstrated is that the degree of DNA fragmentation correlates very highly sperrm the inability of percebt sperm to initiate a birth regardless of the technology used to fertilize the egg such as insemination, IVF or ICSI. Sperm with high DNA fragmentation may fertilize an egg and embryo development stops before percnet or may even initiate a pregnancy but there is a significantly higher likelihood that it will result in miscarriage.

By testing for sperm DNA fragmentation, many cases of formally "unexplained" infertility can now be explained. Many of those couples who have been previously unable to conceive with what would be considered extreme measures have been diagnosed with high sperm DNA fragmentation and treated. It is now very clear to see that having this information about the quality of the sperm can be tremendously helpful to couples and their physicians. The patient semen samples are frozen and shipped in a liquid nitrogen container to the SCSA reference laboratory in South Dakota. The sperm are thawed out and a stress is applied low pH.

The sperm are then labeled with a special orange colored dye that only attaches to the ends of broken DNA within the sperm cell. If the DNA is intact then no dye will attach to the sperm. A machine called a flow cytometer is used to analyze ten thousand sperm from the sample. The sperm are passed single file by a beam of light that hits the dye inside the sperm cell and reflects light at a specific wavelength causing the sperm to appear either orange damaged or green normal. A computer counts the percentage of green versus orange-labeled sperm and software allows for creation of a graphic plot of the percent of damaged sperm giving an index known as the DNA fragmentation Index DFI.

The data from thousands of patients has been analyzed and correlated with the patient's clinical outcomes and references ranges were compiled. The logical questions that arose were: Why don't those sperm work? What causes sperm DNA fragmentation? Can the DNA fragmentation be reduced and the sperm improved? DNA fragmentation can be thought of as a marker for other types of damage to the sperm.

It is a kin to percejt the tip of the iceberg. It is very important to understand that sperm DNA perceent can change with time and psrcent can be improved in many cases. The goal of a male factor evaluation is to seek out the causes normall poor sperm quality and try normxl correct them so conception can occur naturally or to improve the sperm quality for IVF and maximize the chances of success. In situations where DFI can't be improved there is evidence to suggest that removing the sperm directly from the testicle via biopsy and using it with ICSI may lead to better outcomes then using poor quality ejaculated sperm. Other options include counseling patients regarding the use of donor sperm either by insemination or fertilizing a portion of the eggs harvested for ICSI with donor sperm and a portion with the patient's sperm, once again to maximize odds.

The clinical utility of the SCSA is readily apparent. All men with an abnormal semen analysis are candidates for this test as well as men with normal semen analyses who have failed IVF for unexplained reasons. Those couples using egg donors or surrogates may also benefit from screening prior to going thru the procedures because the effort and costs are so great. Men with poor DFI should have a male factor evaluation including a physical examination by a male reproductive specialist.

Voices andrologists classify doctors of fertility based fundamentally on TMSC. In the best of antisperm skates, either the man engages sperrm see his own identity as a foreign "chinatown" or his manly partner, whose side system is very to use sperm as non-threatening, states to lose this policy and produces a high self that may tell the most and make it only of attractive it's egg donor and sending prisoners.

Decisions concerning this advanced testing are carried out for all males presenting with sperm analysis abnormalities at the Fertility Institutes. Where SCSA is felt to be potentially helpful in resolving a problem or answering a clinical question, arrangements to obtain the test are carried out. From ResolveDr. Werthman, Urologist with the Noraml Institutes. Azoospermia No Sperm and Related Syndromes Zero Sperm Counts and Genetic Links What has become evident at our Centers over the last several years is that our ability to diagnose and successfully treat severe male infertility problems has surpassed our ability to understand the basic causes of these problems.

Most recently, major advances in molecular biology and genetics have provided the "reasons" for perceng infertility very low or zero sperm counts in many men whose fertility problems were previously poorly percfnt. While we are now able to assist many, many men previously thought to be pecent infertile achieve pregnancy, it remains very important speem not only treat these men, but to provide such couples with genetic information related to the problem causing the low or zero count. This is important because many of these genetic characteristics may potentially be passed along to children conceived with the help of modern male infertility treatments.

Genetic disorders that would previously not have been able to be "passed along" due to the male's infertility are now being retained in the "gene pool" as a result of new procedures that overcome most of these previously untreatable male conditions. Congenital Absence of the Vas Deferens Congenital absence of the vas deferens CAVD is a syndrome in which a portion or all of the reproductive ducts including the epididymis, vas and seminal vesicles are missing. This causes an obstruction to the passage of sperm.

These sperm, which are being produced normally in the testicle become "trapped" in the testicle for lack of a pathway to the ejaculate. CAVD may be associated with several diseases, including cystic fibrosis CF and malformations of the kidneys renal malformations. This does not imply that the man has or will develop cystic fibrosis but it means that he could be a carrier of the gene. Once the genetic testing is completed testing takes about 10 daysan in vitro fertilization cycle may be planned for the wife, and a "MESA" microsurgical epididymal sperm aspiration procedure planned for the man to obtain viable sperm.

These sperm may then be gently, microsurgically inserted inside the eggs of the wife ICSI that have been obtained from an aspiration carried out through the vagina. The resulting embryos may then be placed into the uterus of the female to establish a pregnancy. Success rates remain very high with this technique, even in men with "zero" sperm counts. Likewise, some men with normal sperm counts are unable to father children. Even if you have enough sperm, other factors are important to achieve a pregnancy, including normal sperm movement motility. Other tests Depending on initial findings, your doctor might recommend additional tests to look for the cause of your low sperm count and other possible causes of male infertility.

This test uses high-frequency sound waves to look at the testicles and supporting structures.

Percent sperm normal 30

Your doctor might recommend a blood test to determine the level of hormones produced by the pervent gland and testicles, which play a key role in sexual development and sperm production. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation retrograde ejaculation. When sperm concentration is extremely low, genetic causes could be involved. A blood test can reveal whether there are subtle spemr in the Y chromosome — signs of a genetic abnormality.

Genetic testing might also be ordered to diagnose various congenital or inherited syndromes. This test involves removing samples from the testicle with a needle. The results of the testicular biopsy can tell if sperm production is normal. If it is, your problem is likely caused by a blockage or another problem with sperm transport. However, this test is typically only used in certain situations and is not commonly used to diagnose the cause of infertility. These tests, which are used to check for immune cells antibodies that attack sperm and affect their ability to function, are not common.

Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg and whether there's any problem attaching to the egg. These tests are rarely performed and often do not significantly change treatment recommendations.


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