FIND OUT MORE ABOUT TESTS AND DIAGNOSIS

Evaluation of sperm parameters is an essential part of a fertility test. It is essential to follow the instructions given prior to the examination, in order to guarantee an interpretable report. In addition, you must respect:

An abstinence period of between 2 and 7 days.
Proper hydration (water) the day before the test.
Urination a few minutes before the test.
Before the test, you will be asked to complete an information questionnaire to assess any risk factors for sperm alteration, which will enable us to interpret your test as accurately as possible.

The results will be sent to you and your doctor as soon as possible.

Spermogram according to WHO

The spermogram is part of the first-line workup prescribed for infertility. The aim is to provide an overall view of the quality of sperm production by the testicles. Various parameters are studied: volume, pH, viscosity, count, motility, vitality, presence of specific antibodies to sperm and sperm morphology. World Health Organization (WHO) standards are our reference values. They are presented in the table below.

Sperm parameters are highly variable within individuals. For this reason, several tests may be necessary before average sperm characteristics can be determined. As a spermatogenesis cycle (sperm production by the testicles) lasts an average of 3 months, a new analysis may be recommended after this time if the initial results are not satisfactory

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TMS: the 24-hour sperm migration and survival test

During sexual intercourse, sperm begin to move through the cervix towards the uterus. The cervix secretes a cervical mucus which changes consistency during the menstrual cycle. During ovulation, the mucus is more fluid, allowing sperm to move more easily. Cervical mucus plays an essential role in facilitating the passage of sperm through the female genital tract. This helps maintain the quality and motility of sperm reaching the uterus and fallopian tubes.

In the laboratory, TMS mimics the role of cervical mucus in sperm migration. Through solutions of different densities. It provides information on the ability of spermatozoa to move and survive, which is linked to their ability to capacitate and successfully fertilize an egg.

In the laboratory, TMS mimics the role of cervical mucus in sperm migration. Through solutions of different densities. It provides information on the ability of spermatozoa to move and survive, which is linked to their ability to capacitate and successfully fertilize an egg.

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Seminal biochemistry (determination of prostate, seminal vesicle and epididymal markers).

Seminal biochemistry refers to the study of the chemical components present in semen, the biological fluid produced by the male reproductive organs. Semen contains a variety of biochemical substances that play an important role in reproduction and fertility. Here are some explanations of the main components of seminal biochemistry:

Fructose: a simple sugar found in semen. It is a biochemical marker of the seminal vesicles, which are glands close to the prostate. Fructose supplies energy to spermatozoa and helps them maintain their mobility. In the case of abnormalities such as agenesis of the seminal vesicles, the dosage of this marker is reduced.
Zinc: plays a number of roles in the sperm, including : . spermatogenesis: necessary for sperm production. . sperm mobility. . antioxidant: helps protect sperm against oxidative damage. Zinc is a biochemical marker for the prostate.
Neutral alphaglucosidase: measured to diagnose potential epididymal obstruction or inflammation, which may be the cause of obstructive azoospermia. Neutral alpha glucosidase is an epididymal marker.

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Sperm bacteriology

This test assesses the presence or absence of bacteria in semen. Note that an infection can occur without symptoms. The presence of an infection can also provoke an inflammatory reaction in the genital tract that is deleterious to spermatozoa. Depending on the bacteria identified and its concentration, the doctor may or may not prescribe a suitable course of antibiotics.

As part of an intrauterine insemination (IUI) or IVF procedure, a sperm culture check is requested every 6 months.

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Sperm DNA fragmentation

This involves measuring the fragmentation of DNA strands present in the nucleus of spermatozoa.

Sperm DNA fragmentation can have a negative impact on male fertility and can be associated with a variety of reproductive problems, such as reduced sperm quality, reduced sperm motility, in vitro fertilization (IVF) failures and recurrent miscarriages.

The causes of sperm D N A fragmentation can be multiple and include:

Oxidative stress : Exposure to high levels of oxidative stress, caused by free radicals and reactive oxygen species, can damage sperm DNA and lead to fragmentation.
Advanced age : Older men tend to have increased sperm D N A fragmentation. This may be due to a progressive accumulation of DNA lesions over time.
Environmental factors : Environmental factors such as exposure to toxic chemicals, ionizing radiation, excessive heat, smoking and alcohol consumption can also contribute to sperm DNA fragmentation.
Infections : Genital infections, such as Chlamydia or Mycoplasma, can cause inflammation and increased oxidative stress, which can damage sperm DNA.

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Post-vasectomy spermogram

A spermogram after a vasectomy is usually performed to check the effectiveness of the procedure and confirm the absence of sperm in the semen. Here are some important points to know about the postvasectomy spermogram:

Delay after vasectomy: A postvasectomy sperm count is usually performed a few months after the procedure to allow sufficient time for all sperm present in the reproductive system to be eliminated. It is usual to perform a first control spermogram around three months after vasectomy.
Absence of spermatozoa: The main aim of the post – vasectomy spermogram is to verify the absence of spermatozoa in the ejaculated semen. In a successful vasectomy, the vas deferens are cut or blocked, preventing the passage of sperm into the seminal fluid. As a result, ejaculated semen should contain no sperm.

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MALE HORMONE TESTS

A male hormone test is often performed as part of an infertility work-up to assess hormonal factors that may be contributing to fertility problems in men. Here are the main hormonal parameters usually included in a male hormone test:

Follicle-stimulating hormone (FSH): This hormone is produced by the pituitary gland and plays a key role in regulating spermatogenesis (sperm production). Elevated FSH levels may indicate testicular dysfunction affecting sperm production.
Luteinizing hormone (LH): LH, also produced by the pituitary gland, stimulates testosterone production by the Leydig cells in the testes. Abnormal LH levels may indicate problems with testosterone production or regulation.
Testosterone : Testosterone is the main male sex hormone and plays an essential role in sperm production and sexual function. Low testosterone levels can be associated with fertility problems.
Growth hormone (GH) : GH, also known as somatotropin, can influence testosterone production and Leydig cell function. Abnormal GH levels can affect male fertility.
Prolactin : Prolactin is a hormone that plays a role in milk production in women, but is also present in men. High levels of prolactin can lead to reduced testosterone production and fertility problems.
Estradiol : Estradiol is the dominant female sex hormone, but low levels of estradiol are normally present in men. High estradiol levels may indicate hormonal problems such as excessive conversion of testosterone to estradiol.
Dihydrotestosterone (DHT : DHT is an active form of testosterone that plays a role in hair growth, the prostate and other tissues. Abnormal levels of DHT can be associated with fertility problems
Inhibin B: : Inhibin B is produced by Sertoli cells in the testicles. It plays an essential role in regulating spermatogenesis, the process of sperm production.

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TREATMENTS

There are several treatments and approaches to improve sperm quality. Treatment options depend on the underlying cause of poor sperm quality. Here are some of the approaches commonly used:

Lifestyle modification: Certain lifestyle changes can have a positive impact on sperm quality. These include maintaining a healthy weight, exercising regularly, reducing stress, avoiding tobacco, alcohol and drugs, eating a well-balanced, nutrient-rich diet, and taking nutritional supplements if necessary
Treating underlying health problems : Certain health problems, such as hormonal imbalances, infections, testicular varicose veins (varicocele) or spermatic duct obstructions, can affect sperm quality. Treatment of these problems can improve sperm quality. For example, surgery can be performed to correct varicoceles or spermatic tract obstructions.
Nutritional supplements : Some supplements can help improve sperm quality. Studies have shown that certain antioxidants such as vitamin C, vitamin E, zinc, selenium and coenzyme Q10 can have beneficial effects on sperm quality by reducing oxidative stress.
Assisted reproduction techniques: If other treatments fail to improve sperm quality sufficiently, assisted reproduction techniques such as artificial insemination or in vitro fertilization (IVF) may be considered. These techniques circumvent sperm quality problems by using laboratory techniques to treat sperm and facilitate conception.
Genetic counseling : In some cases, genetic problems may be responsible for poor sperm quality. Genetic counseling may be recommended to identify genetic factors and discuss treatment options or alternatives, such as sperm donation.

SPERM FREEZING

This is a technique for long-term preservation of sperm samples for future use in fertility treatments.

Who is concerned?

You may wish to consider sperm selfpreservation if:

You suffer from an illness or are undergoing medical treatment for a condition likely to damage the quality of your sperm and cause permanent infertility (e.g. chemotherapy or radiotherapy).
You wish to suspend your fertility for personal reasons (e.g. a professional career).
You are about to undergo surgery (e.g. a vasectomy) and wish to preserve the possibility of conceiving a child in the future.
You are about to undergo an assisted reproduction treatment with your partner, your frozen sperm may be used if necessary (e.g. if you have difficulty producing a sperm sample on the day of the operation or are unable to be physically present on that day).

How it works?

Sperm samples are collected by masturbation or surgical aspiration (testicular biopsy) and undergo a preparation process that includes the addition of a cryoprotectant to protect the spermatozoa from damage caused by freezing.

The samples are then frozen at very low temperatures (-196 degrees Celsius) and stored in cryogenic tanks until they are needed.

What are the limits?

The average sperm survival rate after thawing is around 50-60%. This rate may vary according to the quality of the sperm processed. Therefore, the use of a fresh sperm sample for PMA treatment.

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Fundamentals

CAUSES DE L’INFERTILITÉ MASCULINE

Spermogram according to WHO

TMS: the 24-hour sperm migration and survival test

Seminal biochemistry (determination of prostate, seminal vesicle and epididymal markers).

Sperm bacteriology

Sperm DNA fragmentation

Post-vasectomy spermogram

MALE HORMONE TESTS

TREATMENTS

SPERM FREEZING