The Fertility Institute of Hawaii in Honolulu is one of only a few centers in Hawaii that have the capability to perform a comprehensive male infertility evaluation.
Several factors determine whether a man’s sperm can fertilize an egg. Semen quality and quantity may affect the ability of sperm to fertilize the egg successfully. The ability of sperm to move, referred to as motility, appears to be one of the most important factors in determining the fertilizing capability of sperm. Even with a low sperm count, men with highly motile sperm may still be fertile. The shape of the sperm, referred to as morphology, may also affect its ability to fertilize an egg. In addition, the sperm must live long enough to reach the egg, a characteristic know as viability.
Semen Analysis Testing: a semen analysis is needed to determine how the sperm is to be delivered to the egg. Options for sperm delivery include appropriately timed intercourse, intrauterine insemination, in vitro fertilization (IVF) and IVF with ICSI (intracytoplasmic sperm injection).
Infectious Disease Screening: (HIV, syphilis, hepatitis) With these diseases you may be infected, but asymptomatic, for long periods of time. All of these can be passed along through the semen. The chance of transmission after sperm washing for IUI or IVF is very low.
Genetic Carrier Screening: ACOG recommends that DNA screening for cystic fibrosis and other genetic diseases be available to all couples seeking preconception or prenatal care.
Semen Analysis Testing: Infertility may be caused by many things. Most studies suggest that sperm abnormalities with the male account for about 40% of all infertility, while couples with problems with both partners account for another 20%. The basic test to evaluate fertility in the male is the Semen Analysis.
The purpose of the semen analysis is to:
Note: A physician’s order or consult with Dr. Frattarelli or Dr. Karmon is need prior to scheduling.
Please follow the instructions below for home collections:
At its most basic level, the infertility work-up is trying to determine which is the optimal method to deliver the sperm to the egg. There are 4 ways to deliver the sperm to the egg: (1) intercourse, (2) artificial insemination, (3) in vitro fertilization (IVF), and (4) IVF using intracytoplasmic sperm injection (ICSI).
The semen analysis results are interpreted within the context of the couple’s entire evaluation to provide the most efficient and effective means of sperm delivery for a given situation.
|If the volume is too small, there may not be enough to get to the cervix, if there is too much, it may dilute the sperm.|
|Sperm concentrations may vary widely from within the same individual. Among the factors that can effect the concentration include frequency of ejaculation, environmental factors, surgery/trauma, heat and ingestables (drugs, alcohol, recreational drugs). About 20-25% of fertile men actually have counts below 20 million.|
|This is the proportion of sperm that are swimming. They may swim very fast, moderately fast or slow. The sperm may also wiggle in place or not move at all.|
|Morphology:||The overall appearance of the sperm. The normal range of morphology depends on the laboratory analysis. Please consult with your physician concerning the result.|
|White Blood Cells:
< 1 million/cc
|The presence of WBC suggest that an inflammatory process is ongoing in the male reproductive tract. They can secrete factors that inhibit a sperm’s ability to move and fertilize an egg. White blood cells may be markers for infection, which can be treated with antibiotics.|
Men have the benefit of being able to continuously produce sperm (in contrast to a woman being limited to approximately the 500,000 oocytes that she is born with). This allows men to make behavioral changes that might improve sperm quality. A variety of chemicals are used by men that can adversely affect sperm production and/or function. These include alcohol, marijuana, cocaine, cigarette smoke, and narcotics. For the occasional user of these substances, stopping their use can result in improved semen parameters in 3-6 months for some men.
However, long-term use can result in permanent impairment. A number of drugs also contribute to problems with sperm. These include calcium channel blockers (anti-hypertensives, see list below), cimetidine, spironolactone, nitrofurantoin, sulfasalazine, erythromycin, tetracycline, and anabolic steroids. Other drugs that can be problematic include chromium picolinate, DHEA, androstenedione, colchicines, and methotrexate. Calcium channel blockers are particularly important to know about, as the sperm can appear normal, but not be able to fertilize an egg because of changes induced in the sperm cell membrane by the medicine.
Chemical exposures by other means can affect sperm production/function. These include heavy metals (lead, mercury, boron), organic solvents (acetone, ethylene glycol, benzene, toluene, etc) and pesticides (dibromochloropropane, ethylene dibromide, carbaryl, chordecone). Other physical factors that have been associated with sperm abnormalities or reduced fertility include, heat, vibration (truck driving, bike riding), electromagnetic fields and microwave radiation. Therapeutic interventions might include the use of artificial insemination, donor insemination, in vitro fertilization or intracytoplasmic sperm injection with IVF.
If you are on one of these drugs, it is important to tell your doctor and nurse. Calcium channel blockers can alter the sperm cell membrane so that they cannot fertilize an egg, despite being normal in every other way. If you are not sure about one of your medications, please ask your doctor or nurse.
|Generic Name||Brand Name|
|Verapamil||Calan, Covera, Isoptin, Verelan|
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