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Male Infertility

Semen Analysis:

Semen analysis is gold standard test to see the severity of male infertility.

Normal reference value:

Lowest normal reference value where 5% of population getting pregnancy is –
Count: 15 million
Motility (Forward progressive): 32%
Morphology: 4%
NA Fragmentation: 70 % (N) atleast

Oligo (Less Count)–

  • Mild oligo 10-15 mil
  • Moderate oligo 5-10 mil
  • Severe oligo: < 5 mil

Astheno (low motility)

  • Mild: 20-32%
  • Moderate: 5-10mil
  • Severe: <10%

DNA Fragmentation index:

DNA Fragmentation index indicates beyond count & motility. It directly or indirectly indicate the power of sperm or ability of a sperm to fertile egg. It is quantitative & qualitative estimation of semen.

  • <15% can able to conceive naturally
  • 15-25% antioxidant + IUI
  • >30% IVF & ICSI

Method:

At WINGS we are doing SCD technique which is simple, less laborious& less expensive plus more sensitive.

Other techniques:

  • SCSA
  • TUNEL
  • COMET
  • Double Density Gradient Method:

    Swim the sperm from a two density medium, so at the bottom we will get a best sperm morphologically. It will decrease 15% fragmentation.

  • MACS:

    Magnetic Activated Sell Sorting is a technique where double density gradient passing through a magnetic field, so apoptic sperm (which is in turn toward death program) will attach & non apoptic sperm will be down at the bottom.
    We are doing MACS in

    • Multiple IUI failure
    • Multiple IVF failure

  • IMSI:(Intracytoplasmic morphologically selected sperm injection)

    When we do ICSI, ultimate goal is selection of the scientifically smart sperm in an egg, means we need best DNA packaged sperm can be done by seeing the best sperm under 6000 resolution, It is the last scientific option. It is called IMSI, added advantage on ICSI,
    We are doing at WINGS in

    • Multiple IVF failure
    • Multiple abortion

  • ICSI:

    Intra-Cytoplasmic Sperm Injection (ICSI) is a process where a single sperm is injected directly into the egg using a fine glass needle. The main objective of ICSI is to ensure that the spermatozoa fertilize the egg membrane. The woman is stimulated with medications and then an egg retrieval procedure is performed so that several eggs can be obtained to attempt an ICSI procedure.

ICSI is recommended in cases of severe male infertility, previous fertilization failures with IVF or situations in which there are a limited number of oocytes available.

Steps to follow in an ICSI treatment

  • A very fine delicate needle is carefully inserted through the zona (the shell of the egg) and into the center (cytoplasm) of the egg.
  • The sperm is injected into the cytoplasm and the needle is removed.
  • The eggs are checked the next morning for evidence of normal fertilization.
  • Intricacies involved in an ICSI treatment
  • There is evidence that the babies conceived through ICSI may have an increased risk of chromosomal abnormality. The possibility that a boy conceived as a result of ICSI may inherit his father’s infertility. An increased risk of miscarriage because the technique uses sperm that would not otherwise have been able to fertilize an egg. A low sperm count caused by genetic problems could be passed on to a male child, so you may want to undergo genetic tests before going ahead with ICSI.

Precautions to take after an ICSI treatment

  • Heavy exercise like aerobics, jogging, and weight lifting are prohibited.
  • Smoking or consumption of alcohol should also be avoided.
  • Please consult your doctor before taking any medication.