Male Fertility Diagnosis And Testing
- 1AgeSome studies have suggested that advanced male age (usually over age 50) may lead to increased infertility and increased rates of miscarriage. The data in the literature on this is mixed: some studies showing paternal age to have an effect and some not finding it to be very predictive. If there is an effect of paternal age, it may be a small effect.
- 2Sperm FunctionThe ability of a sperm to penetrate a human egg is an important issue.
Low sperm counts and low motility on the Semen Analysis can often predict whether the sperm that are present are sufficient in numbers and activity to reach the eggs, and then bind to and penetrate them. Other than mixing eggs and sperm in a dish at the time of In Vitro Fertilization (IVF), there is no definitive way to prove that sperm are functioning properly. In rare cases, some men with completely normal Semen Analysis numbers may be found to have sperm that cannot bind to human eggs. Unfortunately, this is usually discovered at IVF.
- 3Sperm DNA IntegrityThere has been much recent interest in evaluating patients with unexplained infertility, multiple reproductive failure and recurrent miscarriage by evaluating the male’s sperm for DNA fragmentation. These tests are not reliably 100% predictive but may indicate in these rarer cases, whether or not the sperm, rather than the egg, is leading to the fertility problem.
- 4Sperm CountThe basic sperm count, achieved by masturbation and examination of the sperm 2-5 days after abstinence is one of the mainstays of making a diagnosis, and should be done even when there is a female factor identified. As many as 40% of couples with fertility problems have issues affecting both partners.
- 5GeneticMen with Klinefelter’s syndrome (47 XXY chromosome makeup instead of 46XY), men with deletions of parts of the Y chromosome, men with balanced translocations, and a few other rarer genetic abnormalities are going to have male infertility.