1. Semen analysis:

Semen analysis is usually the first test to ascertain if the man is the cause for the couple’s infertility. The male partner is the cause of infertility in more than one third of sterile couples.

2. SDI test ( Sperm DNA integrity test)

The DNA quality of the sperm cells is essential for fertilization and proper development of the embryos.

The quality of chromatin in sperm cells is a very important factor for male infertility, especially in the contribution of sperm cell’s genetic material in the early development of the embryo. Research on chromatin structure has a predictive value about the development of the fertilization and success of artificial reproductive technologies. The test gives an idea of the distribution of sperm cells without fragmentation, with fragmented DNA and of those with immature chromatin. The extent of disorders in the genetic material of sperm cells is expressed numerically, and information is presented in % by 2 indexes - DFI (index showing DNA fragmentation) and HDS (index of DNA with immature chromatin).

Researches conducted so far show that sperm cells are classified into 3 groups according to index of fragmentation in relation to their fertility capacity.
• DFI <15% − excellent fertilization capacity

• 15%< DFI <30% − good fertilization capacity

• DFI >30% − low fertilization capacity

• HDS> 20% − increased risk of loss of the embryo in early months of pregnancy

Since SDI test is independent from conventional sperm parameters, SID results may identify a patient with normal sperm parameters to have a DNA damage to a degree comparable to that of men with infertility due to abnormal sperm cells.

Poor SDI results are more frequently observed in men with abnormal semen parameters (low count, motility and/or morphology).

3. Halo test − a method of assessment of DNA damage

In essence this test is similar to the SDI test and assesses in % the structural integrity of chromatin in sperm cells. It is applied in patients with a reduced concentration of sperm cells in the ejaculate (concentration bellow 3 million sperm cell in the whole volume).

4. Test for IgA and IgG antibodies in the ejaculate

Approximately 5-7% of men with infertility problems develop antibodies against their own sperm cells.

These antibodies can have a devastating effect on fertility, covering the cells and obstructing their motility in the female reproductive system.

Anti-sperm antibodies can also prevent the interaction between the egg and the sperm cell which occurs during fertilization. In some cases, these antibodies can damage the formation of sperm cells in the testes.

Anti-sperm antibodies may form after a surgery of the testes, trauma or vasectomy where sperm cells are reabsorbed in the epididymis. There are also cases where the presence of anti-sperm antibodies cannot be explained.In most cases sperm cells form clusters (agglutination).

Their presence is most often due to the fact that sperm cells have a negative surface charge (this uniform electric charge makes sperm cells continuously repel each another); change or loss of this charge leads to cells adhesion called agglutination.

5. Vitality test

Sperm cells are coloured in order to see what percentage of them are alive (this is necessary if there are no motile sperm cells or if the percentage of non-motile sperm cells is > 72%).

6. Assessment of ejaculate for leucocytes

In case of leukocytes (over 1 million) in the semen, this is a signal for an inflammation process in the genital tract like an inflammation of the epididymis (testes, prostate gland, enlarged vein), bacterial infection, etc. Leucocytospermia is associated with increased number of immature sperm cells, increased levels of DNA damage and subsequent failure of fertilization.

Abnormal semen analysis requires conduction of additional tests, such as hormonal tests, biopsies and others.

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