Andrology Laboratory Services

  

 

Semen Analysis

Analysis includes the determination of standard parameters such as semen volume, sperm concentration, motility and progressive motility. Sperm morphology is assessed by modified William’s classification. Strict sperm morphology estimation will be performed upon request. Degree of sperm aggulutination, leucocyte count and liquification time will also be noted.

A retrograde flow of semen into the urinary bladder can be a symptom of the aspermic or oligospermic patient . Sperm recovered from post-ejaculate-voided urine is analyzed, or processed for cryopreservation or artificial insemination

Chemical Analysis

Various accessory sexual glands contribute specific components to seminal plasma such as zinc (prostate), fructose (seminal vesicle) and pH. Such component analysis, along with measurement of semen volume, may aid in the diagnosis of obstructive azoospermia.

Immmonological Analysis

Sera of men and women may contain antisperm antibodies,  associated with reduced fertility. Sperm antibodies often cause agglutination, immobilization or binding to sperm surface. Our immunological assay includes the detection of  Sperm Agglutinating Antibody, Sperm Immobilizing Antibody and Surface Bound Antisperm Antibody (Immunobead Binding Test).

 

SPERM PROCESSING

Semen not only contains spermatozoa, but also various substances that actually inhibit fertilization (de capacitation factors), and prostaglandin. Laboratory sperm processing removes these harmful substances, along with dead or damaged sperm. The processing also concentrates all viable sperm into an amount ideally suited for IntraUterine Insemination (IUI), a process by which a physician clinically places sperm within the uterus directly through the cervix.

Optimum time of IUI depends one any one or all of the following: Hormone levels, ultrasound measurement of your follicles, urinary ovulation prediction kit response, and the sperm quality of your spouse. According to recent studies, double inseminations 24 hours apart report higher pregnancy rates than single inseminations. Regardless, your physician will recommend the appropriate number of inseminations for you based on your age, clinical findings and your spouses sperm quality.

Sperm Availability

The success of IUI depends heavily on the immediate availability of quality sperm. In the event that your spouse is not able to provide a quality ejaculate, a previously obtained ejaculate can be treated and incubated for next-day insemination. As a viable alternative (and a useful precaution), ejaculate can be cryopreserved for longer storage and then utilized whenever needed.

If double insemination is recommended, and sperm quality is sufficient, then half the ejaculate can be processed for same day use, the other half treated and preserved for next day use.

Sperm Processing Fee

Sperm Processing:    $ 170.00

Sperm Treatment:    $ 195.00

Sperm Cryopreservation:    $ 175.00

 

Semen Freezing

Semen freezing or “Cryopreservation” is a procedure by which spermatozoa is sustained in a state of cryptobiosis or “suspended animation” without affecting its fertilizing capacity.

Cryopreservation of semen is a reliable, safe, and time-tested procedure.

Thousands of babies are born every year from the use of cryopreserved sperm.  A variety of patients could benefit by cryopreserving their semen for future use.

 Whose Semen Should Be Cryopreserved?

·        prior to chemo- or radiotherapy

·        prior to vasectomy

·        prior to anabolic hormones or men involved in active physical sports

·        prone to sexual transmissible diseases

·        anticipating questionable future fertility

·        prior to medically assisted reproduction:

                        a) for availability of semen on demand

                        b) to reduce stress of  masturbation on demand

                        c) to select the one with optimal sperm quality

How Many Ejaculates Should Be Cryopreserved?

Depends  on the semen quality, the reproductive health of the couple, and for siblings.  A few insemination doses may be obtained from a single ejaculate. Generally two to six ejaculates are sufficient for cryopreservation.

Freezing and Storage

For cryopreservation, it is preferable to collect an ejaculate following three days of sexual abstinence.  After quality analysis, ejaculate is divided into insemination doses, cryopreserved, and stored in liquid nitrogen (-1960C) in specifically identified and secured containers.  The frozen samples may be kept for many years.

Anyone who wishes to cryopreserve his sperm will need to have an agreement for sperm storage with the laboratory which is renewed annually.

Cost

Semen freezing:              $175. Per specimen            

Storage:                         $325. Per patient (12 months)  

Specimen release:            $50.

Shipping & handling:      $300.         

 

Sperm Function


We offer two sperm function assays simultaneously, which provides reliable and comprehensive identification of male factor related causes of infertility. You can now be confident in:

#       The identification of male factor  related causes of infertility

#       The selection of the appropriate therapies such as IUI, GIFT, IVF, and ICSI

#       The discrimination between true vs. false male factor causes of infertility from failed IVF

      Causes of failure in each step of fertilization can be identified. For the spermatozoa to be fertile, they must be motile with normal morphology and be able to penetrate and migrate into the fertile phase cervical mucus (mucus penetration test). They must be able to undergo plasma membrane changes (Hypoosmotic Swelling Assay), such as capacitation and acrosome reaction, negotiate through the cumulus oophorus and corona radiata, bind (Zona Binding Assay).  

These assays can aid you to specifically address the patient needs.          

Hypoosmotic Swelling (HOS) Assay                                  

Sperm with a physically intact and functionally active membrane will respond to changes in osmolality. This property of the sperm is utilized in the HOS assay which has been shown to correlate highly with the ability of sperm to fertilize intact human oocytes in vitro. It also appears to predict in vitro fertilizing capacity of spermatozoa more reliably than the standard sperm parameters.

Zona Binding Assay

Zona binding assay is a bioassay which measures the spermatozoan=s ability to bind to the zona pellucida. Salt-stored or frozen-thawed non viable human oocytes are tested against patient and donors sperm. This assay can also evaluate patient eggs from failed IVF attempts to determine whether the failure was related to egg factors.

 

Y-Chromosome Microdeletions


This Assay can determine whether or not the genetic material responsible for Azoospermia or severe Oligozoospermia is present in the Y-Chromosome. Statistically, one in five men suffering from either of these conditions can cite such genetic factors.

What Is AMYC Test?

A PCR-BASED analysis for screening eighteen microdeletions which flank AZF regions in the Y-Chromosome.

Microdeletion in:

y         AZFa region causes spermatogenic arrest or oligozoospermia

y         AZFb and AZFc (DAZ) regions cause azoospermia or oligozoospermia

y         AZFd region cause=s azoospermia to normal sperm counts with teratozoospermia

 

Who Needs AMYC Test?

All patients with idiopathic Azoospermia, severe Oligozoospermia or Teratozoospermia should be tested.

Why Test for AMicrodeletion in the Y-Chromosome?

y         To determine the etiology.  Infertility, if proven to be caused by microdeletions, require no further evaluations or therapy.

y         To warn prospective ICSI patients.  Infertility, if proven to be caused by microdeletions, is transmissible.

Early cell differentiation is under influence of the male genome, and therefore in some instances early embryonic arrest is due to a sperm defect.

What is the Incidence of AMicrodeletion in the Y-Chromosome?

Estimates report that more than one in five such men (range between 3 and 30%) have microdeletions.  

What Is Required for the AMYC Test?

A buccal swab sample, taken by the patient and mailed to our laboratory for analysis with a $350 deposit is all that’s needed. Note: Patient’s insurance company will be billed, and once payment is received, the deposit will be reimbursed.

 

Gender Selective Sperm Separation

Sex preference of the offspring has been practiced since the very dawn of humanity and the social and cultural influences have been historically documented.

Many patients have indicated the desire to influence the gender of their offspring through Gender Selective Sperm Separation.

More than 400 sex-linked genetic disorders have been identified. Sex selection by sperm separation therefore is a valuable procedure to avoid the physical discomfort and psychological burden of prenatal diagnosis and selective abortion. Therefore, sex selection for clinical reasons outweigh the ethical or moral issues.

Sex selection by sperm separation is also important for balancing the sex ratio in families to restrict family size.

The efficacy of the established Gender Selective Sperm Separation procedures is questionable. Statistically, anticipated results are far from optimal. Please note that these procedures are extremely time consuming and relatively expensive.

What Is the Gender Selective Sperm Separation Procedure?

·  Female sperm are statistically larger and heavier than male sperm

·  Employing various clinical filtering techniques, an attempt is made to separate female from male sperm

·  Following this (admittedly unreliable) process, a sperm is removed which corresponds to the desire of the couple

Who Needs the Gender Selection Procedure?

         Any couple who have a strong gender preference for their offspring

What is the effectiveness of the Gender Selection Procedure?

The statistical chances for success can vary from 50 to about 80 percent.

What Is Required for the Gender Selection Procedure?

Two days notification is advisable to ensure adequate preparation for the Gender Sperm Processing. Two days of advance notification, and two to three hours of sperm processing time

Costs:

    Each type of procedure takes at least one to three hours sperm processing time.

 

Sperm DNA Integrity (SDI) Test

What Is the SDI Test?

·  Fertility and sperm quality are linked, and an important indicator of sperm quality is sperm DNA integrity and maturity: The more mature and intact the sperm, the better their overall quality.

·  As sperm mature during the course of their development, the chromatin of their DNA condenses. If the sperm is immature, however, then their chromatin will abnormally condense. Also, oxidative stress due to free radicals probably damages the DNA and cause breaks in the DNA strand

·  Determining the extent of these structural defects in the DNA reveals the extent to which the sperm have successfully matured and remained intact, thereby evaluating their quality

Who Needs the SDI Test?

         SDI is highly recommended for the male partners of couples who exhibit:

·  A history of unexplained infertility

·  Poor embryo quality after in vitro fertilization (IVF)

·  Implantation failure after IVF

·  Recurrent chemical or unexplained pregnancy losses, or

·  Recurrent early spontaneous abortions

Why Test for SDI?

Recent research reveals that sperm quality can influence not only fertilization rates, but embryonic development, too. These paternal effects have been shown to influence:

·              Embryo cleavage rates

·              Blastocyst formation

·              Blastocyst implantation

What Is Required for the SDI Test?

SDI may be part of a routine semen analysis, or conducted along with any other sperm assay such as the strict morphology estimation.