Scrotal ultrasound is an imaging technique used for the diagnosis of suspected abnormalities of the scrotum and testes. It uses harmless, high-frequency sound waves to form an image. The sound waves are reflected by scrotal tissue to form a picture of internal structures. It is non-invasive and involves no radiation. It can also detect varicose veins which can negatively affect sperm production mainly due to temperature elevation of the testicular environment.
Sperm DNA Fragmentation assay is meant to test the integrity of the genetic material in the sperm head, which is crucial for successful fertilization and normal embryo development. The higher the DNA fragmentation, the higher is the IVF failure rates and miscarriage rates.
At Astra, we offer our patients an ‘advanced sperm testing panel’ which involves strict sperm morphology and a sperm DNA fragmentation assay. This panel correlates well with the sperm’s ability to fertilize an egg. Advanced testing also includes anti-sperm antibody testing and a trial sperm wash. Simple semen analysis alone is only a screening test and provides very little information about actual sperm function potential. Advanced tests are indicated as a second line investigation, or when the initial semen analysis shows consistently abnormal parameters.
Antisperm antibodies in males arise when the body becomes sensitized to sperm, causing an immune response that destroys his own sperm. Normally, sperm is protected from the immune system by way of a special barrier in the testes.In men who have antisperm antibodies, this barrier has been broken, and the immune system is now able to recognize the sperm and subsequently attack them.
Depending on where the antibodies are located, sperm can be affected in a variety of ways. When the antibodies are found on the tail, sperm tends to be immobilized or may clump together. Antibodies on the sperm head prevent the sperm from properly binding to the egg, thereby preventing fertilization from taking place.
Through our patient centered approach, we strive to identify all factors leading to male infertility. Our goal is to selectively choose investigations for an accurate diagnosis. Astra is proud to be one of the few fertility centers with an on-site andrologist to allow for expert urologic assessment in house. This translates to direct access to a urologist for timely diagnosis and treatment.
With on-site laboratory, diagnostic services and advanced sperm testing, time to diagnosis is shortened significantly. The advanced male workup includes, but is not limited to: advanced sperm testing, scrotal and renal ultrasound, genetic testing for karyotype, and Y chromosome deletion and cystic fibrosis screening.
Once an accurate diagnosis is made, we identify the best treatment options and tailor the approach for each individual couple. Hormonal manipulation for optimization of semen analysis parameters is administered by our urologist.
When surgical procedures are necessary, wait time for the surgical procedure is minimal as Astra has a state-of-the-art independent surgical procedure center where our urologist performs all necessary procedures.
A testicular biopsy is performed in order to find out whether sperm production in the testis is normal or not. This is the “gold standard” for judging testicular function, since here, the testicular tissue is being examined directly under a microscope.
How is a testicular biopsy performed? This is a simple surgical procedure, which can be done under a local anaesthetic. The biopsy takes about 5-10 minutes and can be taken from just one testis, or from both testes, depending on the nature of the problem.
Frequently sperm found on testicular biopsy can be frozen for use in future IVF treatments. Testicular biopsy done with the intent to extract sperm is labelled TESE (Testiculart Sperm Extraction).