Andrology



Semen Analysis



The problem with semen or sperm affects more than one-third of the couples who are unable to have children. Semen analysis is a test performed to evaluate the characteristic of semen and the sperm in the semen sample. The semen analysis is a primary investigation carried out to access the male factor infertility. 

The parameters normally evaluated in semen samples are volume, sperm count, motility, morphology, liquifiction time, pH, WBC count, vitality etc.(WHO has provided the guidelines with the minimum values to be accepted as normal.

These parameters all together predict the normality of the semen sample. The number of sperm, motility and morphology are correlated with the possibility of fertilization. The more abnormal the results of semen parameters, more difficult for man to father a child. However a man with poor semen parameters can father children naturally without any treatment. Further the semen analysis result can help to choose line of treatment like type of sperm isolation technique to be applied, requirement of ICSI etc. Depending on the result of semen analysis further test like sperm function test, testicular biopsy, sperm DNA damage analysis etc. are suggested.

At StemCure we routinely perform semen analysis as per WHO criteria with discreet and confidential measures.


Top

Semen Processing / Sperm Preparation



Sperm preparation techniques have ability to isolate the most functional spermatozoa and reduces or removes seminal plasma and other cellular component from the ejaculate for its application for various procedures like intrauterine insemination (IUI), in vitro fertilization (IVF), Intra Cytoplasmic Sperm Injection (ICSI), Semen freezing etc.

Different methods for sperm preparation are applied, from that most commonly used are swim up and different density gradient. The selection of the method depends on the quality of the semen sample.. The ideal goal of selection of methods is to isolate majority of morphologically normal motile spermatozoa from the sample without damaging its functional capability.

Techniques for Sperm preparation performed at StemCure are in sterile environment using sterile superior quality media and tissue culture grade non toxic disposable labwares that are free of RNAs/RNases, DNA/DNases and pyrogen .


Top

Sperm DNA Damage Analysis



DFI (DNA Fragmentation Index) is the ratio expressed as percentage of sperm having fragmented DNA to the total sperm count.DNA fragmentation in sperm  may be a cause of male infertility which cannot be detected by routine semen parameters like sperm concentration, motility analysis and morphology assessment. 

DNA fragmentation above the critical threshold may cause any of the following:

  • lowers the potential for normal fertility
  • history of pregnancy ended in miscarriage
  • poor embryo development and pregnancy outcome.
  • Good first or second embryo cleavage stages but can affects blastocyst development


Different methods are used for its evaluation like:

  • Sperm chromatin dispersion Assay
  • Tunnel assay
  • sperm chromatin structure assay
  • comet assay
  • Acridine orange staining


Sperm DNA damage analysis may be helpful to a man who has any of the following conditions:

  • Poor semen parameter
  • Unexplained infertility
  • Exposure to harmful toxins
  • Varicocele
  • Multiple failure of IVF/ICSI
  • Poor blastocyst development
  • Repeated miscarriage in partner
  • Elevated scrotal temperature due to occupation
  • Leucocytospermia
  • Advanced age
  • Febrile illness


If the higher % DFI is due to oxidative stress than change in lifestyle and diet may be helpful. When higher percentage of DFI is due to oxidative stress then change in lifestyle and diet may prove beneficial). Varicocele repair, treatment for Genital tract infection, reduced exposure to toxins may be other helpful treatment to reduce %DFI prevailing on the cause of sperm chromatin damage. If high %DFI is evaluated then IUI may not be a helpful ART procedure for such couples and they should be advised for advanced form of ART like IVF, ICSI to increase the possibility of positive outcome. Though one should know that, the risk of birth defect was found to be significantly higher among children conceived through IVF/ICSI, than among naturally conceived children. This could be due to sperm chromatin damage, which in normal fertilization may not able to make an embryo.


Top

Sperm Freezing



There are two purposes of sperm freezing, one for sperm banking for donation and other for autologus use. Sperm freezing for autologus use is done for various reasons like unavailability of male partner at the time of ART procedures; patient is undergoing any treatment which may affect fertility potential, performance anxiety etc.

Sperm freezing is also known as sperm cryopreservation, and is the process which maintains sperm function for extended period of time at extremely low temperature. The cryopreserved sperm upon thawing must be able to perform its normal function, although there are chances of reduction in viability, motility and fecundity of the sperm. In order to minimize such reduction, proper care should be taken to minimize cell damage and prevent lethal intracellular ice formation. The selection of cryopreservation media, cryo container, cooling and warming rate and temperature play very crucial role for effective cryo preservation. . Semen sample is washed by any of sperm preparation technique prior to cryopreservation in order to prevent loss of motility and viability due to seminal fluid.
At StemCure sperm cryo preservation is done for autologus use only. Sperm cryopreservation is executed by our trained personnel as per our established protocol in order to get optimum viability and motility of sperm post thawing. We perform the process in sterile environment using sterile superior quality media and tissue culture grade non toxic disposable labwares, which are also free of RNAs/RNases, DNA/DNases and pyrogen.


Top