Diagnostic of Male Infertility abroad

Approximately 15% of married couples face the problem of infertility. This term refers to the absence of a spontaneous pregnancy within 12 months of regular sexual intercourse without the use of contraceptives. Approximately 40% of cases of infertility are due to a male factor, and in another 10% of cases,both spouses have impaired fertility. Thus, if there are problems with conception, the probability of male infertility is about 50%. Most cases are treatable. Diagnostic of male infertility plays a key role in the fight against this problem since it is necessary to find out the cause of reproductive dysfunction for a successful treatment. If you have encountered difficulties while trying to conceive, you can undergo your diagnostics abroad at one of the best hospitals in the world. You are welcome to use the Booking Health service to find the cost of treatment and choose a medical care program at a specialized hospital.

Content

1. Male infertility diagnostics objectives
2. Types of male infertility
3. Semen analysis for male infertility
4. Other methods of diagnostics for patients with infertility
5. Endocrine male infertility diagnostics
6. Genetic diagnostics
7. Where to undergo male infertility diagnostics?

Male infertility diagnostics objectives

The main tasks of a diagnostic survey for men with infertility include:

• confirmation of the fact of infertility;
• identification of the cause of infertility;
• assessment of treatment prospects;
• determination of indications for different treatment options or overcoming infertility.

In the vast majority of cases, a man can get rid of problems with his reproductive system after a course of conservative treatment, less often after surgery or through the use of assisted reproductive technologies. Very rarely, mainly due to genetic problems, a married couple has to resort to IVF with donor sperm.

Types of male infertility

The diagnostics of infertility only says that conception is impossible at the moment. However, the term does not provide any information about the reasons and mechanisms of fertility disorders. At least laboratory diagnostics are required to clarify this information, and instrumental diagnostics are often required as well.

There are hundreds of diseases and conditions that can interfere with fertility. Primary testicular dysfunction (testicular failure) is the most common cause of poor reproductive health. This condition can be caused by a huge number of factors, including:

• congenital anomalies in the development of the testicles;
• undescended testicle (cryptorchidism);
• varicocele (dilated veins);
• previous surgery;
• consequences of testicular inflammation;
• testicular torsion and partial tissue death due to poor blood supply;
• testicular tumors;
• testicular injuries;
• genetic syndromes;
• the influence of drugs and toxins;
• severe diseases of the internal organs.

In the case of insufficient testicular function, the production of testosterone is impaired, and the maturation of spermatozoa worsens.

There is also a secondary testicular dysfunction. Testosterone production is also regulated by other hormones. Therefore, many endocrine diseases reduce fertility, for example, the increased production of prolactin, pituitary gonadotropic hormone deficiency, or thyroid dysfunction.

Infertility may be obstructive. In this case, the spermatozoa mature but cannot enter the urethra and female genital tract due to the presence of mechanical obstacles. They are detected at the level of the testis, epididymis, vas deferens, or ejaculatory ducts. In some cases, obstruction is amenable to surgical treatment, and in other cases, only IVF will help.

Semen analysis for male infertility

A spermogram is the first test that men take to assess their reproductive function. Based on its results, it becomes clear whether there is infertility or not. If the semen analysis is normal, doctors can focus on examining the woman. Should there be any deviations detected, in-depth diagnostics of male infertility is carried out to determine the reasons.

The main spermogram indicators are as follows:

• ejaculate volume;
• total sperm count;
• spermatozoa concentration in 1 ml of semen;
• sperm motility;
• the structure of spermatozoa;
• time for semen liquefaction;
• pH;
• the number of leukocytes.

A MAR test is usually conducted along with the spermogram. It is aimed at detecting or excluding immunological infertility. With the help of this survey, doctors can assess how many sperm cells are coated with antibodies. If they are less than half, conception is possible. If more than half of the spermatozoa are covered with antibodies, this indicates that the blood-testis barrier is broken. Immune factors penetrate from the systemic circulation into the testicles, damage, and immobilize spermatozoa. It is unlikely that it will be possible to reduce the number of antibodies, and therefore, in such cases, artificial fertilization of the egg is carried out using assisted reproductive technologies.

Other methods of diagnostics for patients with infertility

Based on the spermogram results, doctors can judge the presence of infertility and even suspect what it is related to, which gives a doctor promising directions for further diagnostics. If a man has impaired fertility, other tests can be carried out to determine the cause of disorders:

• a complete blood count to determine sex hormone and other hormone levels;
• infection smears and blood tests;
• an assessment of the prostatic fluid and prostate ultrasound;
• an in-depth semen analysis that may include a biochemical analysis, a more rigorous assessment of morphology, a DNA fragmentation test, and other tests;
• a testicular biopsy;
• genetic tests;
• a brain MRI;
• ultrasound scans of the thyroid and adrenal glands;
• medical imaging of other organs using ultrasound, CT, or MRI scans.

Not every man will need all these tests, as some of them are carried out only if clinically indicated.

Endocrine male infertility diagnostics

Male infertility is most often associated with an impairment of the secretion of hormones or their excess. For the diagnostics of the endocrine infertility factor in men, doctors detect hormone levels in the blood such as testosterone, estradiol, prolactin, FSH, LH, TSH, cortisol and sex hormone-binding globulin.

The most common cause of infertility is hypogonadism, a condition characterized by reduced testosterone production. Low levels of the main male sex hormone is most often caused by primary testicular dysfunction. Less often, it can be caused by an impairment of the formation of hormones in the hypothalamus, which should stimulate the production of testosterone in the testicles. These are gonadotropins, namely FSH and LH. When they are deficient, hypogonadism (testosterone deficiency) is secondary and the condition is treated differently.

Other common causes of endocrine infertility are hyperprolactinemia (increased production of prolactin) and hypothyroidism (low thyroid function). These states are interrelated. Hypothyroidism causes hyperprolactinemia in 40% of cases.

By FSH levels, doctors can also distinguish between obstructive and secretory infertility. If FSH levels are normal, and testosterone levels are not low, the testicles are performing their function normally. Possibly, the low content of spermatozoa in the ejaculate or their absence is associated with obstructive infertility. If FSH levels are elevated, this is a sign of testicular dysfunction.

Genetic diagnostics

In a small percentage of cases, infertility in men occurs due to the reasons caused by genetics. However, these cases are the most unfavorable and are not always amenable to correction, even with the help of assisted reproductive technologies. More than 3,000 genes are known to affect fertility. The most common disorders are chromosomal rearrangements, deletions of the AZF portion of the Y chromosome, and mutations in the CFTR gene.

Doctors abroad use the following methods for the diagnostics of genetic infertility:

• karyotyping;
• a molecular cytogenetic analysis of sperm by FISH method;
• a targeted test of genes associated with syndromic forms of azoospermia;
• exome/genome sequencing;
• a chromosomal microarray analysis can be used in the postnatal and prenatal diagnosis of chromosomal diseases, including microdeletion and microduplication syndromes.

Where to undergo male infertility diagnostics?

Accurate diagnostics of infertility is no less important than treatment. If the cause of male fertility problems cannot be identified, the chances of a successful solution to the problem are low. The errors made during the diagnostics can lead to incorrect therapy or overtreatment. Therefore, it is better to be examined at specialized centers with vast experience. It would be a perfect choice to go abroad. High-quality and accurate diagnostics and treatment abroad will help you to restore your reproductive function or get pregnant with the help of assisted reproductive technologies.

There are a few reasons for you to undergo your diagnostics abroad:

• the cause of infertility can be identified in more than 70% of cases;
• doctors use the latest types of tests, which are more accurate than the similar outdated ones;
• genetic infertility can be successfully diagnosed and cured in many cases;
• hospitals abroad use state-of-the-art equipment for imaging the organs of the endocrine and genital systems;
• you can undergo your infertility treatment, the effectiveness of which exceeds 90%, immediately after your diagnostics abroad.

You are welcome to use the Booking Health service to find the cost of treatment. On our website, you can choose a medical care program and make your treatment appointment at the best price. Please leave your request on the Booking Health website to get a consultation. Our specialists will help you to select the best hospital for your male infertility diagnostics and treatment. When making your treatment appointment through the Booking Health service, the cost of treatment will be lower due to the lack of additional fees for foreign patients.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Center for Biotechnology

Healthline

Verywell Health