Male fertility diagnostic services
Several blood tests will be performed at CReATe on each partner (if applicable) when trying to diagnose and treat fertility problems. Some examples blood tests performed on infertile men include testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, and thyroid stimulating hormone (TSH). There are also other blood tests that may be helpful in the evaluation and treatment of infertility in men, such as testing for genetic problems. The specific tests your doctor will order on will depend on your specific circumstances.
CReATe’s Andrology Laboratory, run by Dr. Sergey Moskovtsev, is one of the most advanced in the world. The andrology laboratory promotes a sequential, multi-step diagnostic approach for the evaluation of males undergoing investigation for infertility. Male infertility accounts for almost one half of all cases of infertility. In nearly one third of male factor infertility, the underlying cause is considered idiopathic (unknown).
For sperm to fertilize an oocyte (a female egg), it must be capable of successfully completing a sequence of events; if any one or more of the steps are compromised the fertilization (fusion of an egg and a sperm cell to form an embryo) may not occur. Results of recent research indicate that sperm quality influences not only rates of fertilization, but also subsequent embryo development and implantation (attachment of an embryo to the womb).
It is essential that a complete and accurate diagnosis be made in order to determine the most appropriate course of therapy to optimize the chances of a successful pregnancy. For instructions on how to provide semen samples for testing at CReATe, click here. There are special circumstances, particularly when sperm numbers are very low, when the instructions here may not apply. Please discuss these with the andrology lab personnel directly to be certain. If you cannot come to CReATe to do your semen sample during the routine hours, it may be possible to accommodate you at another time by appointment only, upon special request.
General semen tests (OHIP Insured)
Routine semen-analysis and computer-assisted semen-analysis (CASA)
Semen analysis is usually the “starting point” for the evaluation of the male partner. It provides an assessment of sperm concentration, motility (the percent moving), and morphology (shape). CASA provides information about the sperm motion and creates an index called the sperm-mucus penetration index. We have evidence that this index may also predict the relative ability for sperm to fertilize an egg.
Anti-sperm antibody testing
Assesses sperm for antibodies, substances produced by the body to attack the sperm and lead to reduced fertility.
Sperm Function Tests (non-OHIP insured, charges apply)
Sperm function tests attempt to determine the ability of sperm to “get ready” and ultimately fertilize an egg.
Sperm penetration assay (spa)
Sperm DNA fragmentation assay (non-OHIP insured, charges apply)
Men with a high percentage of sperm with fragmented DNA (>30%) have low fertility potential with negative effects on fertility. Increased sperm DNA damage has also been linked to recurrent miscarriages. Sperm DNA fragmentation is increase by a number of known factors such as age (especially over 40), prostate infections, exposure of sperm to high temperatures such as saunas, and smoking. However, in many cases, the cause of a high degree of fragmented DNA is unknown. The treatment for a high DNA fragmentation is the use of antioxidants that reduce DNA fragmentation in sperm. We sell a supplement at CReATe that has been formulated with ingredients which can help lower sperm DNA fragmentation.
Fluorescence in situ hybridization (sperm FISH)
This test assesses the number of chromosomes in the spermatozoa. A high frequency of unbalanced spermatozoa (one or more chromosome is missing or an extra chromosome is present) increases the chance of may be associated with miscarriages, birth defects in newborns and genetic disorders in children. The incidence of chromosomal abnormalities is 3-10 times higher in infertile men compared to the general population, and even higher in men with severe sperm defects.
Fertility Preservation and Sperm Banking
CReATe Fertility Centre Andrology Laboratory provides sperm banking service offering patients to preserve their semen for the purpose of achieving pregnancies in the future. There is no limit on how long sperm can be kept frozen in liquid nitrogen. Sperm banking is beneficial in many situations that could interfere with the future fertility. These may include:
- Radiation therapy
- Certain types of pelvic or testicular surgery
- Illnesses (such as diabetes or multiple sclerosis) that may cause erectile dysfunction
- Spinal cord disease or injury
- High risk occupations or sports
- Convenience banking: preparation for a future fertility treatment
Known (Designated Sperm Donors)
This program allows prospective parents to choose a semen donor with whom they have a personal connection, such as a friend or a family member. The program is designed to use the donated semen samples for a single chosen recipient. The screening process for semen donors is very rigorous and is done under the strict directives of the Health Canada Technical Requirements for Therapeutic Donor Insemination. We will provide you with more information if you wish to use CReATe’s designated known sperm donor program.
Men with spinal cord injury (SCI) may require help to have children. Electro-ejaculation and vibro-ejaculation, are methods for obtaining semen from men with SCI who have erection and/or ejaculation problems. Click here to find out more.