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INFERTILITY HOL-emblem1-web.GIF (3556 bytes)

Investigating Infertility

Male Infertility

Quality/Quantity of Sperm

The major cause of male infertility is failure to produce enough healthy sperm. It could be a low sperm count (oligospermia) or a complete absence of living sperm in the semen (azoospermia). The presence in the semen of large numbers of abnormally shaped sperm, such as the two- headed one, may reduce a man's fertility.

Semen Analysis

So, the first thing a infertility specialist do is to perform a semen analysis. Here, semen is examined as soon as possible for the number, shape, and degree of motility of the sperm. A postcoital semen test may also be performed. The semen is analyzed for
bulletConcentration of sperm
bulletSperm quality

The threshold value for a "normal" sperm/semen is shown below.

 

"Normal" Sperm Formation

Criterion

Value

Volume 1.5-5.0 ml
Density >20 million sperm/ml
Motility >30% motile
Normal forms > 60%

The total sperm count and sperm quality of the general male population has been deteriorating over the last few decades.

Total Sperm Supplied by Men Had been Decreasing Over Time

Year Average Sperm Count Amount Of Semen Total Sperm in Ejaculate
1940 113 million/ml 3.4 ml 384.2 million
1990 66 million/ml 2.75 ml 181.5 million

Men are now supplying less than half of the number of sperm per ejaculate compared to 1940 levels.

Functional Tests to Evaluate Sperm

There are several functional tests to evaluate sperm.

The post-coital test measures the ability of the sperm to penetrate the cervical mucus after intercourse.

The Hamster-Egg Penetration Test

This is a "test tube version of the post coital test." Scientists discovered that human sperm, under appropriate conditions, can penetrate hamster eggs. It was established that fertile males exhibit a range of penetration of ten to one hundred percent, and that penetration less than ten percent is indicative of infertility The hamster-egg penetration test is a more reliable indicator of fertility. It accurately predicts fertility in sixty-six percent of the cases, as compared to semen analysis that is accurate only thirty percent of time.

Detection Of Antisperm Antibodies

Another important criteria for suitability of fertilization is the absence of antisperm antibodies in the sperm. If these antibodies are present in the sperm, they will attack the tail of the sperm, thereby impeding the sperm's ability to move and penetrate the cervical mucus. (Women also produces the antisperm antibodies. But the antisperm antibodies produced by women are typically directed against the head of the sperm.) The presence of antisperm antibodies in semen analysis is usually a sign of past or current infection in the male reproductive tract.

Next Topic: Treatment

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