Male Fertility Profile

The male fertility profile is a group of five tests that provide a detailed analysis of male fertility.

 

Semen Analysis

The semen sample is visually assessed under a microscope against key parameters including sperm count, motility and morphology.

 

Sperm Preparation

The aim of the sperm preparation process is to select the population of sperm that will most likely result in successful fertilisation.  The semen is filtered to isolate the healthiest sperm. These are then washed in a solution which contains broad spectrum antibiotics to minimise the risk of infection.  The washing solution also hyperactiviates the sperm to give the sperm even more energy to increase their ability to fertilise the egg.

By performing a semen preparation, we can evaluate whether intrauterine insemination is a possible treatment option and whether IVF or ICSI may be required.  Some sperm may be particularly fragile and not prepare well and this test allows us to identify the treatment option which will give the best chance of a successful outcome.

 

Overnight Survival

Following the sperm preparation procedure, the sperm sample is placed in a special incubator for 24 hours, which mimicks the female reproductive tract. Sperm count, motility and progression are then calculated.  These results are analysed and compared to the original semen analysis.  If 50% of sperm have survived overnight and are progressing well, we would consider this as normal.  If the sperm do not survive well overnight, this may indicate certain treatment types, such as IUI or IVF may not be suitable. ICSI or IMSI may then be the preferred treatment type.

 

Sperm DNA Fragmentation Test

The COMET test measures sperm DNA damage (fragmentation).  Sperm DNA can be damaged when sperm are made, breaking the DNA into smaller fragments. Men with high levels of sperm DNA damage are less likely to get their partner pregnant and have increased risk of miscarriage (1-5). Even if your sperm count is normal, the sperm may not be of good quality, and therefore sperm DNA damage can reduce the chance of you/partner having a baby (1-5).

 

Why should I get tested?

Knowing whether you have sperm DNA damage can help you make informed decisions about the type of treatment and/or lifestyle changes to improve your sperm DNA and fertility.

Can I improve my sperm DNA?

DNA damage is usually caused by oxidative stress. Oxidative stress produces free radicals which attack the DNA molecule causing breaks in the DNA strands. Sperm DNA damage is often associated with underlying medical conditions (such as varicocoele, infection or fever) or certain lifestyle choices (such as smoking or heat).

Your consultant will discuss measures you can take and the best treatment options when discussing your result.

Are there any risks?

Sperm DNA damage testing is a non-invasive procedure performed on a semen sample, usually before treatment as an additional diagnostic test. There are no significant additional risks to the patient.

There is currently no HFEA traffic light rating for sperm DNA damage testing.  It is important to note that whilst there is some evidence for a relationship between sperm DNA damage and fertility treatment outcome, some of this evidence is inconclusive. Please refer to the treatment add-ons page of the HFEA website at https://www.hfea.gov.uk/treatments/treatment-add-ons.6

 

Reactive Oxidative Species (ROS) Test

Oxidative stress (OS) has been known to affect male fertility status and can impair sperm production and function at the molecular level. The production of reactive oxygen species (ROS) by sperm is a normal process but an imbalance is detrimental to the sperm. An imbalance can be caused by an excessive production of ROS or due to diminished antioxidants. This can lead to sperm DNA damage and interfere with other processes involved with fertilisation. Increased oxidative stress is correlated with unexplained infertility and reduced spontaneous pregnancy rates. The results will be discussed with your consultant and a recommendation to start antioxidants may be given.

Laboratory techniques have been developed to evaluate oxidative stress in the semen.  Following testing at CRGH, a result will be given a numerical value and classified as either:

  • Normal
  • A moderate oxidative stress
  • A high level of oxidative stress

The results will be discussed by your consultant and a recommendation to start antioxidants may be given.

 

Contact us

If you would like to book an appointment with one of our doctors you can:

  • Speak to the booking team on +44 (0)20 7837 2905  (Mon – Fri 8.30am – 6pm)
  • Email us on info@crgh.co.uk 
  • Visit our Appointments page, fill out the contact form and a member of the team will be in touch.

References:

1. Robinson, L.Gallos, I.D, Conner, S.J ,  Rajkhowa, M. Miller, D. Lewis, S. Jackson Kirkman-Brown, J. and Coomarasamy A. (2012) The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis . Human Reproduction, Volume 27, Issue 10, October 2012, Pages 2908–2917.

2. Santi, D., Spaggiari, G. and Simoni, M. (2018) Sperm DNA fragmentation index as a promising predictive tool for male infertility diagnosis and treatment management – meta-analyses. Reproductive Medicine Online. Int Braz J Urology. Volume 37, Issue 3, Pages 315–326.

3. Simon, L., Zini, A., Dyachenko, A., Ciampi, A. and Carrell D.T. (2017) A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome. Asian journal of andrology. Jan-Feb;19(1):80-90.

4. Vu Bach, P. and Schlegel, P.N. (2016) Sperm DNA damage and its role in IVF and ICSI. Basic and Clinical Andrology 26:15.

5. Chen Q, Zhao J, Xue X, Zhu G. The association between sperm DNA fragmentation and reproductive outcomes following intrauterine insemination, a meta analysis. Reprod Toxicol 2019; 86:50-55.

6. https://www.hfea.gov.uk/treatments/treatment-add-ons.

IVF Packages With Access Fertility

IVF Packages With Access Fertility
CRGH is partnering with Access Fertility to offer a series of IVF programmes and packages. For more information please click below.

NHS Funding for Fertility Care

CRGH is an NHS approved centre and funding may be available for some patients. You will need to meet certain criteria and be referred to us by your GP. Please call or email us for further information.
Call: +44 (0)20 7837 2905

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