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Diagnosis of infertility in men

Spermiogram

Semen analysis is an important procedure in assessment of male reproductive ability. It is an analysis used to test the quality and clinical, i.e. practical value of the semen. The standards have been defined by the World Health Organization, or other specialized associations, such as ESHRE – European Society of Human Reproduction and Embryology. Pursuant to those criteria, the following clinical conditions can occur:

  • Normozoospermia: normal ejaculate (seminal fluid) in terms of count and motility
  • Oligospermia: low sperm concentration
  • Asthenozoospermia: reduced sperm motility
  • Teratospermia: presence of sperm with abnormal morphology
  • Necrospermia: dead or immobile spermatozoa in the semen
  • Azoospermia: no sperm in ejaculate
  • Aspermia: complete lack of semen

In practice, we often encounter combinations of the aforementioned conditions. Once the referenced procedures are carried out, the sperm is classified as fertile, sub-fertile or infertile. Sperm defect level, determined in the above described manner, often indicates which treatment method should be used in order to have successful results.

Analysis specimen is obtained by masturbation, following not less than two but no more than five days of abstinence (ejaculation). Condoms or lubricants are not allowed, nor can the sample be given after an intercourse, since it can have negative effects on the test results. If the sample is brought from home, it needs to be kept close to one’s body and delivered within one hour upon ejaculation.

The bottle must be sterile and labeled with name, surname, date and place of ejaculation. The Institute pays particular attention to labeling the bottles, so that a switch cannot occur at any point.

 

Semen culture test

It is a microbiological test of semen. Semen culture test is sometimes performed as a routine (e.g. in paraplegic persons), and at other times upon establishing signs of inflammation showed by the semen analysis findings. A treatment, based on an antibiogram, is suggested once the semen analysis findings have been obtained.

Hormonal status

Azoospermia is performed to determine whether there exist any physical obstructions or not. Hormonal status of the male reproductive system is responsible for the above mentioned. FSH and LH level is checked. Once those results are obtained we determine whether sperm is produced but not released, or whether it is being produced at all. Based on those findings we will suggest necessary medical measures.

Testicular biopsy

Testicular biopsy is a diagnostic technique used to determine whether spermatozoa are produced.

Testicular puncture

It is procedure carried out for therapy purposes, upon which the extracted sperm is frozen. Later on the frozen sperm is used in certain IVF procedures.

Karyogram and Y microdeletions

In certain cases infertility is caused by the genetics. Sex chromosome disorder is detected by the karyogram analysis on blood. Molecular DNA analysis for Y microdeletions can be used to detect if there are no genes on Y chromosome.

 

Eldar dr. Mehmedbašić

Zaposlen sam u Zavodu "Mehmedbašić" od 2009. godine. Specijalizantski staž sam obavljao u Opštoj bolnici Sarajevo na Odjeljenju za ginekologiju i akušerstvo te na Ginekološko-akušerskoj klinici, Kliničkog centra Univerziteta u Sarajevu. Specijalista sam ginekologije i opstetricije od 2015. godine.
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