Semen Analysis
The principle of the semen analysis is to assess the macroscopic,
and microscopic, quantitative and qualitative, features of an ejaculate. The
former examines components; liquefaction, viscosity, appearance, volume and pH.
The latter provides an analysis of sperm concentration, sperm motility, sperm
velocity, sperm morphology and sperm viability. Other notable elements of a
semen analysis include the assessment of leukocytes and prominent morphological
defects that may be of a genetic origin.
Sperm Antibodies IgA and IgG
The Sperm Mar test (MAR) enables the detection of sperm-bound
antibodies of immunoglobulin classes: IgG and IgA. The MAR can be used either
as a "direct" test for detecting antibodies bound to a patient's
spermatozoa in seminal fluid, or as an "indirect" test for detecting
sperm antibodies in serum or various reproductive tract fluids.
Sperm DNA Fragmentation Test
Clinical Utility of Sperm DNA Fragmentation Testing
Semen analysis is a cornerstone test used in male infertility diagnosis. However, a significant overlap in sperm
concentration, motility, and morphology exists between fertile and infertile men. In addition, standard
measurements may not reveal subtle sperm defects such as DNA damage and these defects can affect fertility and
embryo development (1, 2). Therefore, sperm DNA fragmentation test may be included in male infertility
investigations.
Sperm DNA Quality and IVF Success
Sperm DNA integrity correlates with pregnancy outcome in assisted reproductive technology cycles (IUI/IVF). Males
with <30 % sperm DNA damage have shown significantly higher pregnancy rates compared to those with > 30%
sperm DNA fragmentation (3). High sperm DNA fragmentation can also compromise fertilization rates, embryo
quality, and early embryonic growth and results in pregnancy loss. In addition, sperm DNA fragmentation seems to
affect embryo post-implantation development in ICSI procedures.
Indications for Sperm DNA Fragmentation Test (4, 5)
- Recurrent pregnancy loss (multiple miscarriages)
- Idiopathic/unexplained male factor infertility
- Multiple failed IUI/IVF cycles
- Clinical varicocele patients
- Patients who have a modifiable lifestyle risk factor of male infertility
References
-
Guzick DS, Overstreet JW, Factor-Litvak P et al. National cooperative reproductive medicine network. Sperm
morphology, motility, and concentration in fertile and infertile men. N Engl J Med 2001; 345: 1388–93.
- Steves SC. et al. Andrologia. 2021 Mar; 53(2): e13874. Sperm DNA fragmentation testing: Summary evidence and clinical
practice recommendations.
-
Evenson and Nixon. Meta-analysis of sperm DNA fragmentation using the sperm chromatin structure assay. Reprod
Biomed Online 12:466-472, 2006
- Agarwal A, Sharma R, Ahmad G. Sperm Chromatin Assessment. Textbook of Assisted Reproductive Techniques, 5th
Edition, 2018.
- Agarwal A et al. The Society for Translational Medicine: clinical practice guidelines for sperm DNA fragmentation testing
in male infertility. Transl Androl Urol. 2017 Sep; 6(Suppl 4): S720–S733
Seminal Fructose
Fructose is qualitatively assessed for presence or absence in
seminal plasma using a simple colour change test. The Seliwanoff assay is
utilised for this test.
Semen Oxidative Stress*
Excessive reactive oxygen species (ROS), produced by both
spermatozoa and leukocytes, are normally eliminated effectively by seminal
plasma free radical antioxidant scavengers and antioxidant enzymes. Assessing
the electropotential of seminal fluid (mV/million sperm/mL) enables the
detection of an imbalance in this biological mechanism, and identifies semen
samples exhibiting Oxidative Stress.
*The
laboratory is currently performing validation work for this test and it will
soon be available as a diagnostic test.