ANDROLOGY

Andrologic Tests

Spermiogram

Requirements:
Collection of sample only through masturbation and in sterile packaging.
Sexual abstinence 3-5 days.
The sample can be taken in the lab or at home and delivered within an hour at the most.
Normal values (According to World Health Organization)

Volume 2.0 ml

Concentration 20x106

Motility 50%

Viability 75%

Other cells 5x106

Morphology 14% *

pH 7.4 - 7.6

* According to Krugger morphological approach *

Possible changes:
Azoospermia: the absence of sperm.
Oligozoopermia: decrease in the concentration of spermatozoa.
Asthenozoopermia: low percentage of normal motility.
Teratozoospermia: low percentage of normal morphology.
Aspermia: absence of ejaculate.
Hypospermia: decreased ejaculate.

Treatment:
Concentration <10 million / Ml: ICSI.
Concentration 10-20 million / ml: IUI.
Normal morphology <14%: ICSI.
Decreased motility: IVF / ICSI.

Anti Sperm Antibodies test

Semen sample
We detect the presence of antisperm antibodies, immune cause of infertility.
Normal Value: ≤ 50% agglutination of motile sperm.

Treatment:
Assisted Reproduction ICSI (Intracytoplasmic Injection of Sperm).

Post-coital test

Sample of cervical mucus on the vagina, endocervix and exocervix, taken between 9-24 hours post-coitus.
Progressive concentration and motility of spermatozoa is observed.

It is considered normal in the presence of progressive motile sperm in the endocervix.
Alteration requires study of cervical mucus.

Evaluation of Cervical Mucus.

Postovulatory sample of cervical mucus.
Assesses Number of mucus, viscosity, arborization, filance, cellularity.
If results are unsatisfactory, then Assisted Reproduction (Intrauterine Insemination) treatment is required.

Achromosomal reaction test

Fresh semen sample
Affinity of the sperm for the egg is determined.
Hyaluronan coated plates are used to simulate with the egg’s wall, and defines the percentage of adhered sperm.

Normal values:
                 - ≥ 80%: Maturation and normal physiological function.
                 - <80%: Maturation and diminished physiological function.

Treatment:
    Assisted Reproduction
                 - 71 - 80%: IUI (Intrauterine Insemination) / IVF (In Vitro Fertilization)
                 - <71%: ICSI

DNA Fragmentation test

Fresh or frozen semen sample
Percentage of sperm with fragmented DNA is determined.
Causes of fragmentation: industrial or environmental toxins, genetics, smoking, defects during spermatogenesis, defective preejaculatory apoptosis, prolonged abstinence, among others.

Normal values:
- <30% of sperm with fragmented DNA.

The presence of Fragmentation greater than 30% is correlated to a probability of pregnancy to term of less than 1%.

Treatment:
- FISH of Spearmatozoa + ICSI

-Frequent ejaculations Pre FISH

FISH
Fluorescence in situ Hybridization

Fresh semen sample
Technique which allows the characterization of part of the spermatozoa’s genetic material.
FISH technique allows us to know how many copies of a chromosome are there in each sperm (percentage of sperm chromosomatically altered aneuploidies) by fluorescent probes for each chromosome.

Chromosomes that are studied:
                 - 13, 15, 16, 18, 21, 22, X, Y

Indications for FISH:
                 - Oligozoospermia, Asthenozoospermia, Teratozoospermia
                 - IVF Failure
                 - Recurrent Abortions

- Advanced Paternal Age

Treatment: ICSI + PGD

Microdeletion of Y chromosome

Peripheral Blood sample with EDTA.
Through molecular analysis techniques based on PCR (Polymerase Chain Reaction).

Indications for consideration:
                 - Severe Idiopathic Oligozoospermia
                 - Azoospermia

Treatment:
                 - ICSI PGD +

Further Studies

USG Testicular Doppler: Diagnosis of Varicocele

Prostate USG: Diagnosis of Obstruction

Due to:

Oligozoospermia
Azoospermia

Hormonal Tests:
LH
FSH
Oestradiol
Prolactin
Testosterone
Testicular failure

Hypogonadotropic hypogonadism
Hyperprolactinemia
Resistance to Androgens