Identifying and supporting male infertility

The Agora Clinic offers additional sperm testing for men

In 2017 scientists reported that the sperm count of men in the developing world had more than halved over the last 40 years. The causes of this dramatic fall are being investigated, but exposure to chemicals is thought to play an important role. Although not all scientists are convinced about this research, the story has helped highlight infertility as much more than just the ‘ticking time-bomb’ facing women.

An enhanced male fertility test

Latest advances in the field of assisted conception all point to the fact we need to assess men’s fertility better. In response, the Agora has developed the Enhanced Male Fertility Screening package to go beyond the standard semen assessments offered by the NHS.

The new package of tests, which includes the standard semen analysis, provides a much better understanding of sperm health and its capacity to fertilise eggs. Our new non-invasive analysis of sperm will help us make the correct diagnosis and fine-tune treatment to ensure the best possible results can be achieved.

The DNA fragmentation test

As the health of the sperm is linked to the health of the embryo, it’s not surprising that high levels of sperm damage, known as DNA fragmentation and measured by the DNA Fragility Index (DFI), have been linked to lower success rates in all assisted conception treatment cycles. Where the DFI is recorded at more than 15% (meaning that more than 15% of the sperm are damaged), fertility treatment success rates are likely to be lower.

High levels of DNA fragmentation have also been found in couples given a diagnosis of ‘unexplained infertility’, as well as in those who have had repeated failed IVF cycles despite producing good embryos. Sperm damage has also been linked to miscarriages.

The DNA fragmentation test can be used as a useful stand-alone test.

Reducing sperm damage

The good news is that, if the DFI score is high, it can be reduced. Lifestyle changes, such as losing weight, reducing alcohol intake and stopping smoking can help prevent sperm abnormalities including DNA fragmentation (when genetic material within sperm is abnormal), as well as improving general health. In some cases, you may be advised to take dietary supplements with antioxidant properties. We may also advise a sperm infection screen as low level infections, although they do not cause any symptoms, can significantly affect sperm health.

As well as measuring the level of DNA fragmentation in sperm, which can cause fertility problems, our new tests look for the presence of antisperm antibodies and include a Hyaluronan Binding Assay (HBA) test to assess whether IVF or ICSI should be used in assisted conception (see below).

Testing for antisperm antibodies

The presence of naturally occurring antibodies in eggs and sperm is a possible cause of infertility which is why antisperm antibodies are included in the analysis. The antisperm antibodies could reduce sperm motility (movement) which, if not detected, may affect fertilisation.

The Hyaluronan Binding Assay (HBA)

Another crucial marker of sperm heath and maturity is the ability of the sperm to bind to the egg (oocyte). The HBA test predicts the ability of sperm to fertilise eggs and provides important information to help us decide whether IVF or ICSI should be offered. This is particularly useful in cases of unexplained infertility.

What do the tests involve?

Men will need to produce a sperm sample which we prepare, freeze and send to our diagnostic laboratory for analysis. This laboratory uses the latest high precision technology, known as flow cytometry, to detect the percentage of sperm with DNA damage.

Next steps

You will receive your results within two weeks, as well as advice on the next steps.

Costs

The Enhanced Fertility Screening Package (single male only) is £320

(this includes semen analysis, DNA Fragmentation, HBA Sperm Binding, antisperm antibodies).

The DNA fragmentation test (which can be done without the other tests) is £160.

If you’d like to know more about this new package of tests or to book a consultation please contact us on 01273 229410 or email us at info@agoraclinic.co.uk