The male factor: The low down on fertility sperm testing

About 30 to 40% of all infertility cases have a male factor as the main cause and 40-50% as a contributing cause. Bearing these statistics in mind, it is somewhat puzzling that women seem to be the first to "blame" when infertility becomes an issue. The bottom line is that just because sperm move do not mean they are capable of initiating making a baby. Thousands of would-be parents can now be saved from costly infertility treatments through a new sperm test called Sperm Chromatin Structure Assay (SCSA) . Reproductive experts used to think that in this era of in-vitro fertilization (IVF) all that were needed were several live sperm to make a baby. Experts now know that this is not entirely the case.

Looking deeper
Dr Ken Gelman is a Cooper City, Florida-based endocrinologist and fertility expert, and one who is frustrated with the medical community that he says often negates the male role in infertility. As Dr Gelman explains, what matters is not only the sperm count, percentage of sperm that swim, how they appear and whether the sperm can penetrate and fertilize an egg, but also the health of the sperm, and the amount of DNA damage inside. "This is really a biochemical issue at the molecular level. Looking at sperm underneath a microscope is very important, but not a perfect way of assessing the ability of sperm to fertilize a woman's eggs or contribute to a birth," he says.

Dr Gelman says the test is able to screen a man for sperm DNA damage, and possible infertility and it is painless, non-invasive, and cost efficient in the sense that it can screen men who might have very unhealthy or damaged sperm before their female partners go through unnecessary infertility treatments. It entails the production of a semen sample and a standard semen analysis is done on one part of the sample and the other portion is frozen and sent to the specialized lab in South Dakota that performs the assay. The percentage of damaged sperm is calculated and the sperm is determined to have good, fair or poor fertility potential. The test determines three key factors:

• What is the likelihood of the sperm contributing to the birth of a healthy baby?
• What percentage of sperm has damage?
• Can the sperm sample be used for in-vitro procedures or should the male partner be treated to improve the quality of the sperm?
  

Dr Gelman says that this test is for men who have had an abnormal semen analysis or have unexplained infertility. "This should be performed before money is invested in IVF treatment because DNA damage may not be repairable," he says. "All of the same factors that have been known to cause male infertility may cause DNA sperm damage such as infections, varicocele, smoking, and exposure to chemical toxins to name a few. The damage is potentially reversible when the stress triggers are removed. Other causes for damage may not be repairable. Studies indicate that those couples have a very poor chance for conception even with IVF and ICSI (Intracytoplasmic sperm injection). These couples should be counseled accordingly."