Fertility Testing For Men

Knowing where you stand gives you control over your future

Male fertility testing is simple and routine. It is important for men to be fertility tested, as male infertility accounts for about one-third of all cases of infertility. Having your fertility tested will give you a wealth of information on your sperm and from there, with the help of our specialists, you can create a plan of action if necessary. Our advanced medical tests are backed with the latest scientific evidence so that you can make informed decisions.

It is important to remember that there is no need to be embarrassed when it comes to your health. Having a fertility check is hugely important if you wish to start your journey to parenthood now or in the future, and the information you will get from a straightforward test will help you to make those steps.

 

When Should You See A Fertility Specialist?

While women may have an idea that their fertility may be an issue, male fertility issues can be asymptomatic. For this reason, we always recommend that couples are assessed as a couple. Some men will already know that they may experience problems in trying to become a father. Some men are born with a fertility issue or may have had an injury during childhood or adulthood, but for many, it is an unknown reason.

 

If you are trying for a baby, see a specialist when:

  • Your partner is under 35 and you have been trying to conceive for 12 months
  • Your partner is over 35 and you have been trying to conceive for 6 months
  • Your partner is over 40 and you are trying to conceive

 

Semen Analysis Testing: €120

A simple semen analysis test will provide a wealth of information about the quantity and quality of both your semen and the sperm it contains. The andrologist (male reproductive health specialist) will check the sample for:

  • How much semen is produced (volume)
  • The total number of sperm in the semen sample (total count)
  • The number of sperm in each millilitre of semen (concentration)
  • The percentage of sperm that are moving (motility)
  • Whether the sperm cells are the right shape (morphology)
  • If antibodies have attached to sperm (anti-sperm antibodies)
  • Whether or you have an infection in your reproductive system

The results will be available to you either the same or the next day.

About a third of couples who attend fertility clinics experience male factor issues, and they find it very reassuring to know that most of them will go on to have a biological child. There are a number of treatments to help get around even the most complicated of fertility issues such as ICSI, a form of IVF treatment.

Sperm is renewed approximately every three months. If you improve your nutrition, exercise in moderation, reduce caffeine and alcohol, and quit smoking or vaping, the quality of your sperm, and your overall health, will improve. Researchers have seen promising improvements when men take zinc, vitamin E, folic acid and selenium supplements, and included whole nuts, spinach and lentils in their diet. If you make these positive changes to your lifestyle, you could see improvements in your fertility in just three months.

Male fertility issues can be things such as low sperm numbers (a “low sperm count”), poor sperm movement, abnormalities in the shape or size of the sperm cells, and sometimes there may be no sperm at all, for reasons such as a blockage in the reproductive tract, or your lifestyle and environment. The following can be causes for male infertility:

 

Genetic Causes

A low sperm count, or the absence of sperm, may indicate a problem with the Y chromosome; in particular Y chromosome microdeletion. Other genetic conditions include Klinefelter syndrome and Kallmann syndrome.

Cryptorchidism 

Also known as ‘undescended testicles’, cryptorchidism is a condition where one or both of the testicles are not found in the scrotum, but in the abdomen. Some men are born without testicles, a condition called ‘anorchia’.

Congenital Absence of Vas Deferens 

If the sperm ducts of a male do not develop properly, there may be an absence of the Vas Deferens, the ducts that carry the sperm from the testicles. If the vas deference is absent, this will result in azoospermia (no sperm in the ejaculate). This condition is linked with cystic fibrosis.

Lifestyle Issues 

Lifestyle choices can have a considerable impact on fertility: things such as smoking or vaping, alcohol intake, recreational drugs, and poor food choices, can all harm the development of healthy sperm.

Sexual Dysfunction 

Many men experience erectile dysfunction. This means they are unable to attain an erection and cannot have penetrative sex needed to conceive. Other men experience problems with ejaculation.

Vasectomy 

Men who have previously had a vasectomy (an operation to make them sterile and prevent pregnancy) can experience what is called obstructive azoospermia.

Varicocele 

A varicocele is a swollen vein on a man’s scrotum which can impact sperm production. 

Infections 

History of a sexually transmitted infection, mumps or inflammation of the testicles may impair fertility.

Other Causes

Chronic diseases such as diabetes and high blood pressure, exposure to radiation, high temperatures, and treatment with chemotherapy are all linked with infertility.

If the results of a semen analysis demonstrate that the sperm is not of good quality, we may suggest some further tests.

 

Hormone Profile Tests: Blood tests may be taken for levels of testosterone, FSH and LH. A raised FSH level may be an indication of testicular failure.

Karyotyping: Blood karyotyping is a test that will explore the chromosomes in the cells. The blood test involves counting the number of chromosomes in a cell or looking for abnormalities in the structure of chromosomes.

Y Chromosome Microdeletion: Y chromosome microdeletions are the most common genetic cause of impaired sperm production and male infertility. This condition is passed from men to their sons, causing them to be infertile.

Cystic Fibrosis Carrier Screening: About two-thirds of men who have an abnormal Cystic Fibrosis gene will also have congenital absence of the vas deferens (a condition where the sperm ducts do not develop properly). Therefore, sperm is not carried from the testicles to become part of semen, resulting in azoospermia.

Cystic fibrosis (CF) is a genetic condition that affects the respiratory system. CF is an inherited disorder that can be passed from parents to their children. A person who has only one copy of the altered gene (a defect in the cystic fibrosis transmembrane conductance regulator gene) is called a ‘carrier’ and will not have any symptoms of the condition. If a carrier has a child with a partner who is also a carrier for CF, there is a 1 in 4 chance that their child will be born with CF. Cystic fibrosis carrier testing tells you your risk of carrying an altered CF gene and can tell you your chance of having a child with CF, but it will not tell you if your child will have CF. In this situation, you may consider Pre-implantation Genetic Testing.

DNA Fragmentation

The DNA Fragmentation test is used to explore DNA damage in sperm cells which may explain the cause of male infertility as the genetic constitution of the sperm is essential for normal embryo development. The test is an additional element of a semen analysis: a semen sample is sent to a sperm DNA fragmentation centre for testing with a view to determining the best treatment method. This is not done routinely as DNA Fragmentation testing is yet to be established as a clinically significant test, and it is a relatively new and expensive test.

If there is no sperm in the semen, patients can undergo surgical sperm retrieval procedures. Sperm can often be retrieved from the male reproductive tract and used, either immediately or in the future, for fertility treatments.

Percutaneous Epididymal Sperm Extraction (PESE): A very small needle is used to aspirate fluid from the testicle. The fluid is examined under a microscope to find sperm to be used for ICSI.

Testicular Sperm Extraction (TESE): A surgical sperm retrieval procedure that can be performed when a patient has no sperm in their ejaculate. If sperm production is occurring, this minor theatre procedure can be carried out to take a biopsy of the testicular tissue. The team will search the biopsy to obtain sperm for immediate or future use.

Microscope-Assisted Testicular Sperm Extraction (MicroTESE): A specialised procedure to surgically retrieve sperm from the male testis using a high-powered microscope. MicroTese is performed under general anaesthetic, in collaboration with University Hospital Waterford.

Intrauterine Insemination (IUI):  For mild male factor infertility, IUI can be a successful treatment. It is a simple fertility treatment where the ovaries are mildly stimulated with medication to encourage the growth of a small number of follicles. Ovulation is triggered and the prepared sperm is placed into the uterus. 

Intracytoplasmic Sperm Injection (ICSI) treatment: This is a specialised fertilisation procedure used in IVF treatment. Instead of placing the sperm with the eggs as in traditional IVF, one of our skilled embryologists will inject a single sperm into each mature egg. The sperm can be produced or surgically retrieved for this procedure. The ICSI procedure maximises the chance of fertilisation as it bypasses any potential problems the sperm may have in penetrating the outer shell of the egg.

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