Semen Analysis

Semen analysis is used to assess male fertility. A macroscopic examination of the semen specimen is performed for pH, volume, color, viscosity, and liquefaction. A microscopic analysis is performed to assess concentration, motility, motility grade, cellular debris, agglutination, and white blood cell and round cell concentration. Additional testing for the presence of fructose or viability of the sperm may be required based on the semen analysis result.

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Sperm Antibody Testing -Direct/ Indirect

The detection of sperm immobilizing and sperm agglutinating antibodies can be found in the serum of the male or female. Sperm immobilizing antibodies (also known as cytotoxic antibodies) interfere with capacitation and the acrosome reaction that occurs when a sperm penetrates an egg. Sperm agglutinating antibodies affect the ability of the sperm to migrate within the female reproductive tract and fertilize eggs. Testing for antibodies is indicated in patients with excessive agglutination in the ejaculate, decreased motility, or poor sperm-mucus interaction on post coital test, unexplained infertility, or vasectomy reversal. Patients positive for immobilizing and/or agglutinating antibodies may have fertility problems, and therefore, may need to implement special procedures in order to achieve pregnancy.

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Hamster Egg Penetration Assay (HEPA)

Sperm must penetrate the egg (ovum) before fertilization, and ultimately pregnancy can occur. HEPA measures the sperm’s ability to penetrate an egg through natural intercourse or artificial insemination. The sperm is treated with two types of media (HTF and TYB), and the treated sperm is then incubated with zona-free hamster eggs (oocyte) for several hours prior to analysis. HTF (Human Tubal Fluid) media imitates the natural environment of sperm, where as TYB (Test Yolk Buffer) is a buffering agent that enhances the fertilization capability of sperm. Results indicate whether advanced assisted fertilization techniques such as IVF or IVF/ICSI may be needed to maximize the sperm’s fertilizing potential. The proper treatment of the sperm for artificial insemination ( WASH versus WASH/TYB) is also assessed from HEPA results. Our Andrology Laboratory is the only lab in the local area performing this assay.

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Strict Morphology

Studies show that semen with < 14% normal morphology may have decreased fertilization capability. Strict morphology testing is used as a predictor of fertilization capability by determining the percentage of normal sperm present in semen. Sperm are stained and each section of the sperm (acrosome, midpiece, head, and tail) is carefully analyzed with oil microscopy according to size and shape. Results are interpreted using Kruger’s strict criteria.

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Fructose Assay

The presence of fructose in the semen is normal. There is no sperm present and no fructose present in the semen of a male with congenital absence of the vasa deferentia, dysgenesis of the seminal vesicles or ejaculatory duct obstruction. When a male is found to be azoospermic (no sperm is present in the semen), the fructose assay is performed to test for the presence of fructose in the semen. If the fructose test is negative, further investigation can be done to determine if one of the above mentioned conditions is the cause of the azoospermia.

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Viability Testing

The Eosin Y and HOS test is performed when abnormal motility is assessed on semen analysis. The Eosin Y Vitality test is performed to determine whether non-motile spermatozoa are vital or non-vital. The sperm are stained with Eosin Y and assessed for vitality. The HOS test is performed to determine the percentage of viable (live) sperm in a semen specimen. The HOS test is based on the principle of fluid transport across the sperm membrane. Live sperm will take in fluid and display changes in their tails (swelling or coiling). A semen specimen with abnormal motility, but a normal percentage of vital sperm may indicate structural defects of the sperm or the presence of immobilizing antibodies.

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For additional information please call our Andrology Lab at (414) 649-2045
or email ceallabs@aiof.com.