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Male investigations and treatment options

Male investigations and treatment options

Initial investigations, including semen analysis, may not always prove conclusively that a man is infertile. So, we go one vital step further by offering more revealing investigations in which we can detect very minute quantities of sperm, too small to register in conventional analysis, and we isolate these for harvesting.

We also run regular clinics to assess male fertility issues and undertake surgical sperm retrieval.

ICSI is a viable treatment option for men with a sperm count of 10-20. However, if the sperm count is lower, there is still a chance of avoiding using donor sperm as PESA or TESE techniques can be used to extract viable sperm. However, successful surgical extraction can never be 100% guaranteed.

We can also tell you if there’s a zero sperm count, known as azoospermia. In most cases azoospermia means there’s no need to consider the cost of surgical extraction and we can help you to find donor sperm.

Semen analysis

If you are asked to provide a semen samples for analysis, this should be produced when you attend the centre so that the analysis can take place immediately after production. However, if you feel you are unable to produce a sample on-site, please speak to one of our laboratory staff to discuss alternative arrangements.

Please make sure that you do not ejaculate for three days prior to producing a semen sample for analysis. This is important as it will ensure a good sample in terms of numbers and quality.

The analysis

The following will be assessed during the semen analysis:
o The number of sperm present within the ejaculate (the sperm count)
o The number of sperm that are moving (the motility)
o The number of sperm that are normally formed (the morphology)
o Whether or not there are anti-sperm antibodies present
o The ability of sperm to survive over a 24-hour period
o Whether there is any infection present within the sample

Results

The results of your semen analysis will be available within seven working days and you will have the chance to discuss them with your consultant. To protect patient confidentiality, we do not provide results over the phone, although you can request a written report.

What is a normal semen analysis result?

• A semen volume of greater than 2mls
• A sperm count of at least 15 million sperm per ml
• At least 40% of the sperm will be motile (active)
• At least 4% will be normally formed
• Less than 50% of the sperm will be affected by antisperm antibodies

The degree of variance from these accepted normal values will be assessed and the implications explained by your consultant during a follow-up consultation.

Some men diagnosed with infertility problems may have been told that there is no sperm found in the ejaculate following routine semen analysis. This condition is known as azoospermia. However, we can offer additional semen analysis tests that can detect even minute quantities of sperm, too small to register in conventional analysis. We can isolate these sperm for harvesting using advanced sperm retrieval techniques including a PESA or TESE procedure.

Hormone assessment in men

In cases of azoospermia, blood analysis of the hormones FSH, LH and testosterone will be taken. This will tell us if there is a blockage, if no sperm is being produced within the testis, or if there is a lack of hormones.

If a hormonal problem is detected it may be necessary to have medication in the form of injections to aid sperm production. If there is a blockage sperm can either be retrieved through PESA, or surgery might correct the problem. In the second instance, and in 50% of the cases, Testicular Sperm Extraction (TESE) will retrieve enough sperm to fertilise the egg. In exceptional cases, where the levels of testosterone are too low, hormone replacement therapy will be advised.

Testicular biopsy

Testicular biopsy involves taking one or several small samples of the testes - either for analysis, or for the recovery of sperm in the most severe cases of azoospermia. These samples are tested immediately or cryo-perserved for use at a later stage.

Male investigations and treatment options

Initial investigations, including semen analysis, may not always prove conclusively that a man is infertile. So, we go one vital step further by offering more revealing investigations in which we can detect very minute quantities of sperm, too small to register in conventional analysis, and we isolate these for harvesting.

We also run regular clinics to assess male fertility issues and undertake surgical sperm retrieval.

ICSI is a viable treatment option for men with a sperm count of 10-20. However, if the sperm count is lower, there is still a chance of avoiding using donor sperm as PESA or TESE techniques can be used to extract viable sperm. However, successful surgical extraction can never be 100% guaranteed.

We can also tell you if there’s a zero sperm count, known as azoospermia. In most cases azoospermia means there’s no need to consider the cost of surgical extraction and we can help you to find donor sperm.

Semen analysis

If you are asked to provide a semen samples for analysis, this should be produced when you attend the centre so that the analysis can take place immediately after production. However, if you feel you are unable to produce a sample on-site, please speak to one of our laboratory staff to discuss alternative arrangements.

Please make sure that you do not ejaculate for three days prior to producing a semen sample for analysis. This is important as it will ensure a good sample in terms of numbers and quality.

The analysis

The following will be assessed during the semen analysis:
o The number of sperm present within the ejaculate (the sperm count)
o The number of sperm that are moving (the motility)
o The number of sperm that are normally formed (the morphology)
o Whether or not there are anti-sperm antibodies present
o The ability of sperm to survive over a 24-hour period
o Whether there is any infection present within the sample

Results

The results of your semen analysis will be available within seven working days and you will have the chance to discuss them with your consultant. To protect patient confidentiality, we do not provide results over the phone, although you can request a written report.

What is a normal semen analysis result?

• A semen volume of greater than 2mls
• A sperm count of at least 15 million sperm per ml
• At least 40% of the sperm will be motile (active)
• At least 4% will be normally formed
• Less than 50% of the sperm will be affected by antisperm antibodies

The degree of variance from these accepted normal values will be assessed and the implications explained by your consultant during a follow-up consultation.

Some men diagnosed with infertility problems may have been told that there is no sperm found in the ejaculate following routine semen analysis. This condition is known as azoospermia. However, we can offer additional semen analysis tests that can detect even minute quantities of sperm, too small to register in conventional analysis. We can isolate these sperm for harvesting using advanced sperm retrieval techniques including a PESA or TESE procedure.

Hormone assessment in men

In cases of azoospermia, blood analysis of the hormones FSH, LH and testosterone will be taken. This will tell us if there is a blockage, if no sperm is being produced within the testis, or if there is a lack of hormones.

If a hormonal problem is detected it may be necessary to have medication in the form of injections to aid sperm production. If there is a blockage sperm can either be retrieved through PESA, or surgery might correct the problem. In the second instance, and in 50% of the cases, Testicular Sperm Extraction (TESE) will retrieve enough sperm to fertilise the egg. In exceptional cases, where the levels of testosterone are too low, hormone replacement therapy will be advised.

Testicular biopsy

Testicular biopsy involves taking one or several small samples of the testes - either for analysis, or for the recovery of sperm in the most severe cases of azoospermia. These samples are tested immediately or cryo-perserved for use at a later stage.

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