The andrology consult allows the identification of the possible presence of anatomical abnormalities and alterations caused by infectious or traumatic processes by inspection and palpation of the male genitals.
SEARCH FOR ANTISPERM AUTOIMMUNE ANTIBODIES
Antisperm antibodies are proteins that bind to the surface of the spermatozoa, inhibiting the functionality and therefore causing an interference to the process of fertilization. This exam is performed using a sample of seminal fluid and evaluates the presence of two major classes of immunoglobulins: IgA and IgG.
SPERM DNA FRAGMENTATION TESTING
The alterations in the structure of sperm DNA seems to affect negatively the results of the PMA techniques (Henkel et al, 2003).
The assessment of the percentage of spermatozoa with fragmented DNA is carried out by using enzymes which bind to the marked nucleotides at the break-points in the DNA double helix. The test, carried out by TUNEL (Terminal Deoxynucleotidyl Transferase UTP-driven Nick End Labeling), considers as pathological, percentages of fragmented DNA of over 20-30%.
The F.I.S.H. (Fluorescence In-Situ Hybridization) test is a genetic analysis that is carried out on a sample of seminal fluid to determine the possible presence of numerical abnormalities of chromosomes (in general 13, 18, 21, X and Y) in sperm cells. This method involves the use of markers that bind specifically to the DNA of the spermatozoa and can therefore be viewed by fluorescence microscopy. The chromosomal abnormalities can be divided into aneuploidy and diploidy. Aneuploidy is characterised by an alteration of the normal haploid makeup of the sperm cell (which has 23 chromosomes in normal conditions). There may therefore be conditions of disomy due to the presence of an extra chromosome compared to normal or nullisomy when the contrary is true where one chromosome less than the normal 23 can be found. Diploidy is when there are two pairs for each chromosome analysed. In patients with serious diseases affecting seminal fluid, there is a higher frequency of numerical alterations in the X and Y sex chromosomes that can be inherited by children.
It is an analysis that is carried out on a sample of seminal fluid to search for the possible presence of microbiological populations that can determine inflammation in the genital tract and sometimes impair fertilization.
SPERM SEPARATION TEST
This method consists in removing by washing seminal plasma and assessing the “best” fraction of spermatozoa for motility and morphology. There are several procedures to obtain this selection however particularly:
Swim-up (ascending migration)
Separation on a density gradient
SEMINAL FLUID EXAMINATION (SEMINOGRAM)
This exam shall be carried out on the sample of seminal fluid obtained by masturbation. To carry out the exam on the seminal fluid, a period of sexual abstinence (ejaculations) of 3 to 5 days (not more) is necessary.
It is absolutely important to wash your hands and genitals efficiently before carrying out collection in a sterile container for urine. Our facility offers a dedicated room equipped with television and DVD to facilitate the procedure.
Seminal fluid is constituted by two components: a fluid component (seminal plasma) and a cellular component (spermatozoa). This examination consists in counting the population of spermatozoa and is carried out in the laboratory under the strict international standards proposed by the World Health Organization (WHO).
Specifically, the following parameters are assessed:
Fluidization and viscosity
Volume and pH
Concentration of spermatozoa per volume unit
Percentage of movable forms
Concentration of movable forms per volume unit
Morphology of the spermatozoa in the sample
One speaks of oligospermia: if the sperm count is less than 15 million/ml; asthenozoospermia: if progressive motility is less than 32%; teratozoospermia: when the percentage of spermatozoa with abnormal morphology exceeds 96%; azoospermia when there are no spermatozoa in the seminal fluid. This exam is not able to determine male fertility in an absolute manner since ascertained paternity is the only sure test. In addition, a single seminogram is not able to determine the potential state of fertility (sperm production by the testis is extremely variable).