Testing for sperm quality and quantity
About a third of all problems with fertility are due to male infertility issues. Often a man could be completely healthy, but produces poor quality sperm. Some men may have more serious medical problems, such as low male sex hormones, or testosterone levels.
Semen analysis is the most important male infertility test, providing an accurate measurement of the number of sperm, their motility (ability to move), their morphology (size and shape), as well as the volume and consistency of the ejaculated sample.
The examination is best performed on a specimen less than two hours old and obtained by masturbation, with the entire amount ejaculated collected in a sterile container.
Standards vary from laboratory to laboratory, so it is best to have the analysis performed at the Hunter IVF andrology laboratory, where further tests are possible. If we find abnormalities, we often require repeat tests to assess the type and degree of the problem, and whether it is a persistent feature.
Cryopreservation (freeze storage) of sperm is also available.
Our trained Andrology scientists assess semen appearance, colour, pH and leucocyte presence. They count the sperm numbers (concentration) and the sperm motility (how fast sperm are moving).
The morphology (shape) of sperm is also assessed. If indicated, the sperm vitality can also be counted (the percentage of immotile sperm that are alive or dead) based on the effects of a dye on the sperm.
If sperm stick to each other head-to-head, tail-to-tail or in a mixed way, this is known as agglutination and the presence of sperm antibodies may be the cause.
Sperm penetration into the cervical mucus, and the success of IVF treatment, tends to be significantly reduced if more than half of the motile spermatozoa have antibody bound to them. We’ll perform a binding test, to determine whether semen has antisperm antibodies that may be impeding fertility.
This is a test we’ve performed for over 15 years that includes a full semen analysis and antisperm antibody assessment. The sperm is then prepared as if for an assisted reproductive technology (ART) procedure.
Preparing sperm for all these processes involves removing any immotile and misshapen sperm from the sample, and preparing the sperm into a highly motile, clean pellet. In this process, this reduces the number of sperm from the initial semen sample so it indicates whether semen sample is suitable for any planned ART treatment.
Also known as the ‘sperm DNA test’, this measures the population of sperm with fragmented DNA, as genetics can have a negative impact on the success of your fertility treatment.
If you have extremely low sperm numbers (severe oligospermia) you can still have them assessed using TUNEL as we can adjust the machine settings to ensure that more sperm are analysed than could ever be seen through a microscope.
There are treatment options for patients with mid range DNA damage (15-30% DNA Fragmentation Index), or high range DNA damage (>30% DFI).
Is Tunel Assay right for you?
This test is highly suited to men who:
- Have had leucocytes on detected by semen analysis,
- Are approaching 50 years of age,
- Have a past history of prostatitis or Type II diabetes,
- Are exposed to workplace chemicals or extended increased heat.
It also has benefits for couples who have:
- A past history of recurrent miscarriage,
- Poor fertilisation results,
- Poor embryo quality and embryo development,
- A long history of unexplained infertility,
- Had two or three failed ART attempts.
Some men pass some or all of their semen into the bladder during ejaculation. We then need to examine two samples:
- The ejaculated sample samples (the antegrade ejaculation sample), and,
- The sample that needs to be retrieved from the bladder (the retrograde ejaculation sample)
Organising semen analysis at Hunter IVF
If you are a current Hunter IVF patient, your fertility specialist will provide a request form, or you can ask your GP for a referral to Hunter IVF for a semen analysis test. You should call Hunter IVF on (02) 4957 8515 to make an appointment.
You may produce your semen sample at home but request it is then delivered to the laboratory within one hour so as not to compromise the analysis. You may use a private room within our clinic at the time of your appointment if this is more convenient.
Instructions for providing a semen sample:
- Special sterile specimen containers are available from your GP or Hunter IVF.
- Avoid intercourse or masturbation for 2–5 days before the test.
- Write your full name and date of birth on the specimen container.
- Produce the sample by masturbation, without lubricant or condoms. If masturbation is not acceptable, we can provide a special condom to collect a sample during intercourse at home.
- Deliver the sample to the laboratory within one hour if produced at home. In transit, keep the sample near body temperature, for example in a pocket close to the skin.
Checking underlying causes
Diagnosis of the causes of male infertility may require blood tests for the hormones, follicle stimulating hormone (FSH), and testosterone. These play a role in the development and maturation of sperm. A chromosome analysis (karyotype ) and other tests may be conducted if the sperm count is very low or zero. Referral to an andrologist (a specialist in male reproductive disorders), may be necessary or advised..
Find out more about male causes of abnormal sperm production
Meet our Fertility Specialists
Contact us for more information