Usually, the most common infertility test is semen routine, in fact, there are also sperm morphological examination, acrosome reaction, chromosome and so on, but in order to avoid excessive examination, save the economic and time cost of examination and physical damage and so on, not all of them will be done at the beginning.
1. Semen examination is roughly divided into three steps.
Step 1: Check the semen routine to examine the overall semen condition and help the doctor find the direction to further find the cause of the disease.
Step 2: Checking in-depth aspects of semen according to disease characteristics: such as infection indicators, trace elements, antibodies, DNA fragmentation, acrosome analysis, etc.
Step 3: going further, genetic issues such as chromosomal and Y chromosome microdeletions may be considered.
This is like enemy reconnaissance or map enlargement, which needs to be carried out step by step, layer by layer, for the significance of each of the following tests, combined with the analysis of individualized principles. So a special reminder to sufferers, you need to buy a plastic hard cover file bag to protect each and every one of your test results (regular hospitals have a standardized process, combined with the unique experience of doctors), to see infertility needs enough time, the information must be left up before and after to facilitate the doctor’s analysis, in addition, sperm test requires abstinence for 3-7 days, you can go directly to the general simple outpatient checklist.
2.What are the semen tests? What is the purpose of each examination?
Semen routine: semen color, volume, sperm concentration, semen liquefaction time, semen pH, sperm motility (percentage of forward-moving sperm or a+b sperm), viability and morphology, and round cell concentration.
Purpose: To understand the general condition of semen and to make a preliminary determination of the presence or absence of “enemy conditions” or possible areas of concern.
Seminal plasma biochemistry: mainly includes neutral alpha-glucosidase and fructose, carnosine, acid phosphatase, lactate dehydrogenase.
Purpose: To contribute to the understanding of the function of the epididymis, prostate, and seminal vesicle glands. Neutral α-glucosidase and fructose reflect the secretory function of epididymis and seminal vesicles respectively and their patency, and are suitable for patients with azoospermia or severe oligospermia who are suspected of having vas deferens obstruction; seminal plasma acid phosphatase is a marker of prostate gland function, and this test is important for patients with poor semen liquefaction; seminal plasma lactate dehydrogenase test is a key enzyme for sperm motility and energy, and this enzyme test can assist in determining sperm quality The test can help determine sperm quality and predict sperm fertilization ability.
Sperm acrosome analysis: It mainly includes sperm acrosome integrity rate and sperm acrosome enzyme activity analysis.
Purpose: It reflects to a certain extent the ability of sperm to fertilize egg cells and is suitable for patients with unexplained infertility and those who are ready for IUI or IVF.
Infectious indicators of semen: seminal plasma elastase test and semen leukocyte staining.
Associated microbiological tests.
Purpose: Elastase is a protein enzyme secreted by neutrophils in the lobulated nucleus during inflammation, and is a marker of male genital tract inflammation. The presence of genital tract inflammation can be determined by this test in combination with semen leukocyte staining; the concentration of round cells in semen routine is also considered as one of the indicators of semen infection; to understand the presence of urinary and reproductive system infections and their associated pathogenic microorganisms (bacteria, viruses, spirochetes , mycoplasma, chlamydia, etc., commonly gonococcus, papillomavirus, adenomatous, chlamydia trachomatis, etc.).
Anti-sperm antibody (AsAb) test: The main test is the semen mixed antiglobulin test (MAR test).
Purpose: To detect patients with poor sperm motility, high sperm agglutination or unexplained infertility.
Sperm nucleus DNA fragmentation analysis: To analyze the percentage of sperm with DNA fragments in the nucleus of the sperm.
Purpose: It is suitable for infertility patients whose female partner has unexplained miscarriage and embryonic abortion, and infertility patients who are ready for IVF treatment, because a high rate of sperm nuclear DNA fragmentation indicates that the proportion of sperm with DNA fragmentation in the sperm nucleus is too high, which may affect sperm-egg union, embryo quality, etc.
Seminal plasma trace element analysis: the most common ones are zinc test, phosphorus, etc.
Purpose: For those with low sperm motility and high malformation rate. Zinc, as a cofactor of more than one hundred enzymes in the body, is an essential and important element related to human growth and development, and is closely related to the metabolic activities of the reproductive system. The detection of seminal plasma zinc has certain guiding significance for the treatment of male infertility.
Chromosomal and Y chromosome microdeletions: Generally, chromosomal examination is also required in two cases: multiple routine semen examinations of the male partner.
Purpose: To find out whether there are congenital factors in male infertility patients, applicable to sperm density less than 10 million/mL; those with a history of two (including two) or more spontaneous abortions, especially early abortions (within 3 months of pregnancy).
3.If all the tests are normal, is it basically confirmed that the male partner has no problem?
If all the above semen tests are normal, and the male partner has a normal sex life and a reasonable sex time (reasonable intercourse: start the day before ovulation and have sex on the next day, 3 times in a row, usually can fully cover the ovulation period; usually regular sex, 1-2 times a week, do not “mess with sex” because of fertility.) If genetic tests such as chromosomal and Y chromosome microdeletions and thalassemia mutations are also normal, the male partner’s fertility cannot be confirmed to be absolutely normal, but this is where the focus of screening should shift to the spouse; if both partners are normal, further analysis may be required.
If they are not normal, further analysis and diagnosis is needed in the direction suggested by the abnormality.