Just like your physio wouldn’t start treating you before figuring out what’s causing the problem with your hamstring or (hopefully) the mechanic won’t just drop in a new gearbox without running a diagnosis, your GP or Fertility Specialist often need to order some routine tests to identify any specific issues before developing a personalised fertility treatment plan for you. If you’re a hetero couple, we run tests on both the male and female partners, so we have all the relevant information to hand when planning the next baby step. All of these tests are key as they ensure the treatment designed for you addresses your specific fertility issue.
Male infertility is more common than you might think. In approximately 40% of cases where couples have trouble conceiving, the problem lies with the man. Problems with sperm production, or alternatively a problem blocking sperm from getting into the ejaculate can both contribute to male factor infertility. So, male testing involves an analysis of semen and checking physical structures.
ook, we know this isn’t going to be the top of your Christmas wish list, but a physical examination is pretty important to check for physical issues such as:
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- Undescended testis - This is when the testis has not reached its normal position in the scrotum which stops it from functioning properly and may stop it from producing sperm.
- Testicular size – testes that can only hold a small volume are associated with poor sperm production.
- Whether the tubes that carry sperm from the testes to the outside world are present or not.
Yep, it’s that awkward moment that we’re talking about. When you provide a sample to our scientists, this is what we’re looking for:
- Number and movement (aka concentration and motility). A healthy ejaculate has over 40million swimmers with at least half of them moving normally. If a man isn’t producing enough sperm, it significantly lowers the chance of conception.
- Shape (aka morphology). A healthy sperm has an oval head and a long tail to help it swim like a champion. Sperm with abnormal shaped heads or curled/double tails are less likely to fertilise an egg.
A more detailed look at sperm can also include testing DNA:
- The genetic information (DNA) carried in the sperm head needs to be healthy. If there’s DNA damage, the embryo might not develop properly, and there’s a risk of miscarriage. A regular turnover of sperm leads to less DNA damage, regular ejaculation is important so, in this case, thinking sexy thoughts can help.
Sometimes the number, movement, shape and DNA are all healthy, but the man’s immune system accidentally makes anti-sperm antibodies which prevent the natural binding between sperm and eggs (doh). We can test for that too.
If you and your partner have experienced recurrent miscarriage or one or both of you have a genetic condition in your family, your Fertility Specialist may review both partners for chromosome abnormalities. If the blood tests detect abnormalities, your Fertility Specialist might discuss with you our genetic screening and testing options - Pre-implantation Genetic Diagnosis or Pre-implantation Genetic Screening.
Even without any obvious family history, anyone planning pregnancy should consider having testing to ensure that you don’t carry the same quiet genetic (recessive) condition as the person you plan to get pregnant with. Many of us carry one recessive condition which in itself doesn’t cause disease, however, if both people carry the same recessive gene (examples include cystic fibrosis and spinal muscular atrophy) – then you have a 1 in 4 chance of having a baby with a serious medical disorder. Your Fertility Specialist will offer this testing which is undertaken by an external pathology company.
Your Fertility Specialist or GP may order an ultrasound to check for:
- Obstructions – which prevent the sperm from leaving the male reproductive system.
- Scrotal varicocele - large veins (aka varicose veins) wrapping around one or both of the testicles which may impair the ability of the scrotum to cool down. This can seriously affect sperm quality.
- Any pre-cancerous change in the testes – men with very low sperm counts have a higher risk for this.