Male infertility may be due to dysfunctions related to the production, release or functionality of sperm, the male sex cells.
CFA's medical team will assess, side by side, with our patients, the possible causes of infertility by collecting their clinical history, suggesting additional investigations and examinations to discussing and planning the best future strategy.
First and foremost, we need to collect the patient's medical history: looking at urogenital infections, such as measles or mumps, sexually transmitted diseases and chronic diseases, such as diabetes and hypertension . Surgery or genital trauma, sexual habits such as the use of prophylaxis or spermicide, frequency of sex, sexual dysfunction and life-spans and the use of alcohol, smoking and drugs.
The standard examination in diagnosing male infertility is the spermogramme, or the study of the seminal fluid. In addition to the chemical-physical properties (volume, pH, fluidization and viscosity), the sperm concentration, motility and morphology are examined; the parameters are then compared with standards of the World Health Organization. Particular attention is also given to the presence of other cell (blood cells, epithelial cells, immature sperm cells and white blood cells). Further examinations may also be required depending on the outcome of the spermiogramme.
Here we evaluate the presence of particular micro-organisms (bacteria and fungi) that may play a role in some pathologies of the genital system. Knowing which strain of bacterium we have present, allows our doctors to suggest a precise antibiotic therapy.
Our doctors will check the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL) and testosterone (T) in the patients blood. Altered levels may affect the production of sperm.
Ultrasound investigation of the Prostate and Testis
Gives us information on anatomical and functional aspects of these organs.
Cytological examination of testicular tissue.
If we are unable to detect spermatozoa in the ejaculate, we may proceed to aspiration or surgical exploration of the testis, isolating small amounts of tissue directly from the various testicular zones (upper, middle, lower, and epididymal poles) and analyze them to confirm azoospermia (absence of spermatozoa).
Immunobead Test (IBT) and other immunological tests
These tests determine the presence of antibodies on the sperm surface. In fact, antibodies may interfere with transport in the female genital tract or the fertilization process itself. In women, anti-sperm antibodies can also be highlighted in genital secretions (eg in cervical mucus) and in the blood.
Sperm DNA Integrity (Tunel Assay)
This test detects anomalies in the organization of the DNA in the mature spermatozoa). Sperm with normal morphology and motility but with anomalies in the DNA, called fragmentation, are sub-fertile.The Tunnel Assay is a direct method to detect damage to the nuclear genome and highlights and quantifies fragmented DNA within a total population of spermatozoa.
FISH Test (Fluorescence In-Situ Hybridization) to test chromosome numbers
Aneuploidy is a condition in which the sperm cell does not have a correct number of chromosomes, which should be 23. It may have too many or too few. This evaluation is performed in fluorescence microscopy using DNA-specific probes for chromosomes 13, 18, 21, X and Y.