Male Infertility

I. Definition
Infertility is defined as inability of a couple to conceive after 12 months of unprotected sexual intercourse or can not carry the pregnancy to full term. It effects over 5 millions couple alone in the U. S. and many times more in the world, because of unawareness of treatments, only 10% seeks help from professional specialist. In fact, More than 40% of infertility of a couple is caused by male inability to fertilize. Diagnosis is a analytics approach, after initial consultation and medical history and personal information have been taken from a patient or couple. The main objective conventional diagnosis is to find the causes of infertility, but unfortunately, it has less than 1% successful rate. We will try to give you the definitions of type of diagnosis used .

I. Medical history and physical exams
Before reading the definition of types of diagnosis, you may want to know briefly what information is recorded on your personal file
I. General medical history
1. Any miscarriage, previous pregnancies and abortion.
2. Any ectopic pregnancy
3. Any previous surgery
4. Have you now on HRT.
5. Use of conceptive method, type of use
6. Any reproductive chronic pain including STD. urinary tract infection ad chronic diseases.
7. Medication you are taking now
8. Any medication of your mother during pregnancy to rule out infertility caused by birth defect
9. Your lifestyle.

II. Physical Exam
a) Testicle related including injure, childhood testicle illness and abnormal in birth
b) Age of puberty
c) Number of previous sexual partners
d) Question related to ejaculation and impotence
e) Do you have child with other women
f) Have you ever contacted and treated with sexual transmitted diseases
g) Hot bath
h) Smoking and drugs abuse
i) Expose to radiation
j) workplace hazard
k) Medication may influence your sexual organs.
l) Other general exam depending to your specialist (herbalist or others)

III. Male Infertility Diagnosis
1. Acrosome reaction test
After the sample is taken your fertility specialist exam the acrosome reaction of your sperms to see how your sperm penetrate the female egg, how the enzymes (acrosome then acrosin released from the sperm head ) in sperm work through tough coating of the eggs and fgertilized it. The purpose of this test is to diagnosis the sperm acrosome then acrosin to see hoe these enzyme help to break tough surface of the egg. If not it may be the cause of infertility and specific treatment is required. It happens only 5% of infertility male population.

2. Antisperm antibody
An antisperm antibody test as defined as a test to look for abnormal function of immune system antibodies that fight against a male's sperm in blood, vaginal fluids, or semen. With a substance added to the sample sperm, the test will tell whether the sperm is affected by proteins of the immune system or not.

3. Biochemical analysis
The study of the chemical substances and vital processes occur in male testicle such as the concentration of white blood cells, the level of fructose in the semen, and the volume, pH, and liquefaction.

4. Computer-Assist semen analysis
The sample of sperm is scanned in to the computer pre store program to show how the sperm quality, quantity, shape and movement. Since any small change of the computer may produce a significant change in sperm calculation, therefore any abnormal sperm count should be confirmed by manual count.

5. Hemizona assay
Hemizona assay is the analysis to compare sample sperm of the male to the sperm of the fertilized male by splitting the mature and normal egg into 2 half. 1/2 is tested by sample sperm and the other half is tested by fertilized male sperm.

6. Hormone evaluation
Hormonal evaluation is a study to measure the levels of certain hormones produced by your body such as levels of FSH and testosterone which are involved directly in sperm production. The test will only be used if the semen of sperm analysis comes back with low density of sperm or your specialist suspects that hormone imbalance is the cause of infertility.

7. Human zona pellucida binding test
The testes help to exam how the sperm bind to outer layer of the egg including hemizona assay.

8. Hypoosmotic swelling test (HOST)
hypoosmotic swelling test (HOST) is the test used to identify sperm membrane for structure integrity by examining how the sperm tails react to special sugar and salt. Only healthy sperm can react in that circumstance.

9. Pene trak
Pene trak is the test for 90 minutes to check the movement of sperm through a normal and friendly mucus in the test tube.

10. Peroxidase staining
It is a test to check for infection by differentiating white blood cell from the immature sperm.

11.Post-coital/cervical mucus test
It is a test to see how friendly the mucus of the cervix toward the sperm invasion a few days before and after ovulation. The result can be determined after
a) Male partner sperm with female partner cervical mucus
b) Male partner sperm with healthy mucus
c) Known healthy sperm with female partner mucus
d) Known healthy sperm with known healthy muscle

12. Sperm penetration assay (hamster test)
Sperm penetration test only is needed if the normal semen test can not determine the sperm penetration ability then hamster eggs with the ouster membrane has been stripped off are used in place of female eggs because of it's structural similarity to human eggs. After the sperm and hamster eggs have incubated for three hours, the eggs are checked for sperm penetration. Any percentage over 10 % is considered normal and potential for fertilization. Since it is used eggs other than human being, good sperm penetration rate in hamster test does not guarantee 100% of positive result in human.

13.Sperm-Ubiquitin tag immunoassay (SUTI)
Sperm-Ubiquitin tag immunoassay ignores other sperm attributes and focus solely on sperm's ubiquitin because ubiquitin is considered as a universal marker of any sperm abnormalities including sperm damage and sperm defective, thereby reducing some unnecessary treatments.

14. Semen analysis
A semen analysis is usually the first test for all infertility male , it helps to measure the amount of semen a man produces and determines the quantity and quality of sperm such as size, shape. movement and PH level in the sample.
a) Normal form sperm
Ovary head, single tail with intact midsection and an uncoiled.
b) Abnormal heads
Head of sperm if too big or too small and other than ovary head.
c) Abnormal tails
Coil, broken, bent tail and other than single tail.
d) Immature gen cells
Since white blood cells and white gen cells have a very similar appearance and structure, it is up to the specialist to make sure that the present is immature gen cells and not white blood cells.
e) Vital staining
It is the analysis to see the percentage of dead sperm compare to lice one.


15. Scrotal sonography
Scotal sonography is used to evaluate the testicle disorder and surrounding organs including prostate gland, epididymis, an absent or undescended testicle and any testicle abnormality.

16. Testicle biopsy
A small sample is taken and tested for the ability of sperm producing cellsl in normal cells production. This test is necessary if the infertility male is found to have no sperm in semen, normal sex levels of hormone and abnormal sperm with unknown cause. The risk of the test may cause testicle damage.

17. Vasography
Vasography is a Radiographic study of the vas deferens. It helps to determine if the vas deferens is blocked or not and the reason of such blockage. In this study, if there is large amount of sperm containing fluid presented when the vas deferens is open, it indicates there is a block appeared in the vesicle end of the vas deferens. If there is no fluid presented, the procedure continue until the cause of blockage is found, if there is one.