Male Fertility at Fertility First
You will need the following:
1. Blood tests
Fasting bloods for full blood count, inflammatory makers, liver, kidney, thyroid, diabetes and cholesterol tests.
Iron tests to rule out haemochromatosis.
Tests for sexually transmitted diseases (if indicated).
2. Sperm count
Fertility awareness and sexual health.
Lifestyle and nutrition advice.
3. Sperm DNA Fragmentation
Sperm are the vehicle by which a man's genetic information (the DNA) is carried to the egg. The possible effectiveness of the vehicle to deliver this message is assessed at routine semen analysis but the quality of the DNA itself is not assessed, ie we look at the messenger not the message. Nuclear alterations, such as an abnormal chromatin structure, micro-deletions in the chromosome, or DNA fragmentation, will all reduce the sperm's ability to produce a viable embryo.
Sperm DNA fragmentation is inversely related to the sperm's ability to fertilize. Thus, when the percentage of cells with DNA fragmentation is high, it may be less likely that a sperm from that semen sample successfully fertilizes an egg.
The Sperm DNA fragmentation test, can examine the D.N.A. in a man's sperm for tiny, but significant, breaks. This test is now available in "The Cremore Clinic" in Dublin where we run fertility clinics in general practice for couples having difficulty conceiving. It does require that the man produce a fresh sample of sperm, preferably here in the surgery as it has to be frozen within half an hour of production and sent it to a special laboratory for testing on the same day.
Healthy male sperm have fewer breaks and make healthy babies and there is less chance of women miscarrying when the sperm has fewer DNA breaks. One in six couples has difficulty conceiving. In about 40% of cases, the problem is related to male factors. Prior to the fragmentation test, doctors relied on semen analysis. But the clinical value of semen analysis is very limited and often couples are told the semen is normal while they still cannot conceive. About a third of couples traditionally were told they had "unexplained infertility".
The DNA fragmentation test can now explain quite a lot of these cases and can fast track couples to the best treatment strategy for them. All men have some breaks in their sperm DNA and below 15% is considered normal. If the breaks in the man's DNA are between 15% and 30% we now know that IVF (In vitro fertilization) may succeed. However if the DNA breaks are more that 30%, IVF is unlikely to work and this couple should be referred directly for I.C.S.I., (Intracytoplasmic sperm injection), where the sperm is injected into the egg.
The really good news for men is that millions of new spermatozoa are produced every few months (unlike women who are born with all the eggs they will ever have and the eggs therefore age with them). Men can alter their lifestyle and their drinking and smoking habits and can often improve the quality of their sperm. Obviously the woman is also a very important part of the potential family and we like to see couples for a full fertility workup prior to the DNA fragmentation test.
So there is new hope out there for couples who are longing to have a baby and whose attempts have been decimated by infertility and miscarriages. Men long for a child just as much as women do and the DNA fragmentation test can often help a couple become a family.
To make an appointment please call our team on (01) 834 4611.