fertility tests for men

Fertility Tests for Men: Options and How They Work

Many infertile couples have more than one cause of infertility, so it's likely you will both need to see a doctor. It might take a number of tests to determine the cause of infertility. In some cases, a cause is never identified.

Infertility tests can be expensive and might not be covered by insurance — find out what your medical plan covers ahead of time.

Diagnosing male infertility problems usually involves:

• General physical examination and medical history. This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Your doctor might also ask about your sexual habits and about your sexual development during puberty.
• Semen analysis. Semen samples can be obtained in a couple of different ways. You can provide a sample by masturbating and ejaculating into a special container at the doctor's office. Because of religious or cultural beliefs, some men prefer an alternative method of semen collection. In such cases, semen can be collected by using a special condom during intercourse.

Your semen is then sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections.

Often sperm counts fluctuate significantly from one specimen to the next. In most cases, several semen analysis tests are done over a period of time to ensure accurate results. If your sperm analysis is normal, your doctor will likely recommend thorough testing of your female partner before conducting any more male infertility tests.

Your doctor might recommend additional tests to help identify the cause of your infertility. These can include:

• Scrotal ultrasound. This test uses high-frequency sound waves to produce images inside your body. A scrotal ultrasound can help your doctor see if there is a varicocele or other problems in the testicles and supporting structures.
• Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to check your prostate and look for blockages of the tubes that carry semen.
• Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems might also contribute to infertility. A blood test measures the level of testosterone and other hormones.
• Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation).
• Genetic tests. When sperm concentration is extremely low, there could be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.
• Testicular biopsy. This test involves removing samples from the testicle with a needle. If the results of the testicular biopsy show that sperm production is normal your problem is likely caused by a blockage or another problem with sperm transport.
• Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg, and whether there's any problem attaching to the egg. These tests aren't often used and usually don't significantly change recommendations for treatment.

 

fertility tests for men

How does IVF work

IVF is a common treatment for people who are unable to conceive naturally

Usually in IVF, the woman has medicines (fertility hormones) to stimulate the ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory.

IVF is carried out when the sperm quality is considered to be ‘normal’ If there are issues with the sperm quality such as low motility or numbers, a procedure called intracytoplasmic sperm injection (ICSI) may instead be used – this is where a single sperm is injected into the egg by an embryologist

If fertilisation is successful, the embryos are allowed to develop for between two and six days. This helps the embryologist to select the strongest embryo, which is then transferred back to the woman’s womb to hopefully continue to a successful birth.

Often several good quality embryos will be created. In these cases, it's normally best practice to freeze the remaining embryos because putting two embryos back in the womb increases your chance of having twins or triplets, which carries health risks. You can use your frozen embryos later on if your first cycle is unsuccessful or you want to try for another baby.

What does IVF involve?

This process outlines a single cycle of IVF following the most commonly used procedure. You may find that your treatment is slightly different depending on your history and what your clinic thinks is best for you.

• Usually, the first step is to use medication to stimulate the ovaries to produce eggs. There are different ways this can be done. One way is to suppress natural hormones before taking hormone medication to stimulate the ovaries. This treatment, often called a long protocol, involves taking a daily injection or nasal spray to suppress hormone production. A scan checks the woman’s natural cycle is fully suppressed. If it is, hormone treatment (usually gonadotrophin) is started to boost the number of eggs the body produces.
• Some clinics may use the ‘antagonist protocol’. This involves taking medication (an antagonist) to suppress your hormones for a few days after you have taken the hormone medication (usually gonadotrophin) to boost the number of eggs the body produces.
• Whichever way the ovaries are stimulated to produce eggs, you will be closely monitored for a few days by the clinic. This may involve having blood tests or ultrasound scans.
• The eggs will be collected whilst under sedation or general anaesthetic. The procedure takes around half an hour and you may feel a little sore or bruised.
• Whilst the eggs are being collected, the man will be asked to come to the clinic to produce a sperm sample, or your donor sperm will be taken from the freezer, for mixing with your eggs.
• Medication will help to prepare the lining of the womb. This is usually taken as a pessary or gel which you can insert yourself into the vagina / rectum.
• The eggs will be mixed with the sperm in a laboratory. The aim is for the eggs and sperm to fertilise to create an embryo.
• If fertilisation happens, the resulting embryo(s), will be monitored to check how it’s/they’re developing.
• Two to five days after fertilisation, the embryo(s) will be transferred to the womb. You won’t need any kind of anaesthetic for this unless you have a condition that would make the procedure painful. You’ll be given a date to do a pregnancy test. Although you’ll understandably be excited at this stage, try not to do this early as you may get a false result.

Tips to Improve Egg Quality

Here are 7 Tips to Improve Egg Quality and Boost Fertility

Women often ask if there is a natural or 'at home remedy' for boosting egg quality and improving fertility and the changes of pregnancy. Dr. Hirshfeld-Cytron explains what you can do to ensure that your eggs are the best that can be when preparing for conception.

1. Stay Away from Cigarettes.

Smoking permanently speeds up egg loss in the ovaries. The chemicals in cigarettes mutate the DNA in a woman's egg cells, making some of the eggs unsuitable for conception. Women are born with all the eggs they will ever have, and the number of eggs reduces with age, so it is best to keep eggs healthy and free of unnecessary chemicals.

2. Manage Stress.

Stress can produce hormones such as cortisol and prolactin that can interfere or halt ovulation, which also hinders egg production. Stress-reducing activities such as yoga, meditation, exercise or a warm bath can help keep stress and frustration at bay.

3. Eat Healthy.

Healthy foods improve overall health, this includes helping your eggs stay healthy and high quality, as well as improve overall fertility. Eat plenty of leafy greens, whole grains, lean meats, nuts, fresh vegetables, and fruits. Stay away from trans fats, refined carbs, processed foods or meats, and excessive salt and sugar.

4. Achieve a Normal BMI (body mass index).

Obesity has been linked to reduced fertility and decreased egg quality due to alterations of mitochondrial function and increased oxidative stress. Being overweight can also alter hormonal balance, disrupting ovulation. A body mass index (BMI) between 18.5-24.9 is recommended to achieve pregnancy. To give you an idea of what that looks like, a woman that is 5’6” falls within a normal BMI with a weight range of 115-154 lbs.

5. Boost Blood Flow.

Good egg health is aided by oxygen-rich blood flow to the ovaries. Blood flow in the body can quickly decrease from dehydration, so aim to drink 64 oz. of water each day. Yoga is a healthy and relaxing way to improve blood flow, with poses such as the lotus pose, child’s pose, reclining hero and seated forward bend offering a specific fertility benefit.

6. Invest in Supplements.

No need to break the bank on vitamins, but there are three low-cost options that can help with egg health: Coenzyme Q10, melatonin and fish oil. CoQ10 can boost mitochondrial function as well as antioxidants, improving the quality of eggs (200 mg, 3x daily); melatonin can boost antioxidants, encourage ovarian function and aid in sleep (3mg each evening); and fish oil (EPA/DHA) can help produce higher quality eggs and help reproductive function in advanced maternal age (1200-1500mg EPA + DHA daily, do not exceed 3000 mg/day).

7. Freeze Your Eggs.

If you are planning on delaying motherhood, the best way to protect your fertility future is to stop your biological clock and freeze your eggs. With time, a woman’s natural fertility declines, but frozen eggs remain the same biological age as when they are cryopreserved, boosting your chances of future success.

How does the egg donation process work?

Egg donation is a process in which a fertile woman donates an egg, or oocyte, to another woman to help her conceive. It is a part of assisted reproductive technology, or ART.

The procedure typically involves a doctor removing an egg or eggs from the donor, fertilizing them in a laboratory, and then transferring the resulting embryos into the recipient’s uterus. Doctors do this using an implantation procedure, such as in vitro fertilization (IVF).

Sometimes, specialists at the facility may freeze some or all of the embryos for later use or implantation in different women.

Egg donation frequently benefits women who cannot use their own eggs for various reasons, including ovarian failure, avoiding congenital anomalies in the fetus, or advanced age.

One 2014 entry in the journal Fertility and Sterility suggested that 93 percentTrusted Source of all fertility centers in the United States offer egg donation. The same study indicates that the procedure results in a successful birth 49.4–50 percent of the time.

In this article, we look at the criteria for selecting donors, the procedure itself, and legal ramifications following an egg donation.

 

 

The clinic will conduct a thorough selection process for potential donors.

Specialists at the fertility facility will conduct an intensive selection process to find a suitable donor and will carefully run through the legal procedures.

Before starting the procedure, most donors will need to take medication that stops their normal menstrual cycle.

Side effects of this medication might include:

• hot flashes
• headache
• fatigue
• body aches

The donor will then take a series of fertility drugs that stimulate the ovaries to produce several eggs at once. This is known as hyperstimulation. Donors will need to self-administer this medication by injecting it under their skin or into a muscle.

Some women may experience mild side effects, such as bruising at the injection site, mood swings, and tender breasts. In rare cases, a woman may develop severe ovarian hyperstimulation syndrome (OHSS). This occurs when too many eggs develop in the ovaries. Women who develop OHSS may require hospitalization.

Donors do have a risk of pregnancy before the eggs are retrieved, so it is a good idea to avoid intercourse or use a barrier contraceptive, such as a condom.

Throughout the donation cycle, a donor will undergo frequent blood tests and ultrasound examinations to monitor their reactions to the medications.

 

During extraction

Shortly before the retrieval of the eggs, the donor will receive a final injection in preparation for the procedure.

The doctor will perform a transvaginal ovarian aspiration to remove the eggs from the donor’s ovaries. They will insert an ultrasound probe into the vagina and use a needle to remove the egg from each follicle.

During the procedure, which lasts around 30 minutes, the doctor might give the donor painkillers, sedatives, or an anesthetic.

As this is a minor procedure, a donor will not need to stay at the clinic or hospital overnight.

After donation

Some women find they need several days of rest to recover from the transvaginal ovarian aspiration. Others return to normal activities the next day.

Some programs provide aftercare to donors, but others do not. As the egg donation process can have a psychological impact, some women may find it useful to work with a counselor or psychotherapist after the procedure.

 

How does the egg donation process work?

Egg Quality in Women

The peak fertility for women is reached around age 25 and remains about the same until approximately age 32, when it begins to decline. At age forty, the rate of decline accelerates and by age 42 a woman has lost almost 70% of her fertility potential. This trend continues until menopause, which occurs around age 51 on average in the U.S.

 

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At birth there are approximately 1-2 million eggs in the ovaries. This number falls to about 500,000 at the time of puberty and results in approximately 400 ovulations during the reproductive years. The development of eggs is controlled by the pituitary gland which releases a hormone called Follicle Stimulating Hormone (FSH) that stimulates follicular growth. Inside of each follicle is an egg, surrounded by granulosa cells and follicular fluid. The follicle produces estrogen, which signals the brain as a feed back. At the beginning of a woman’s reproductive life span, the ovary responses readily to stimulation from the brain to produce a mature egg. However, over time the number of eggs decreases in the ovary. These remaining eggs do not respond as easily to the FSH signal from the brain, which makes more FSH in an attempt to stimulate the ovary to produce an egg. We measure the FSH and estradiol (E2) on the third day of the menstrual cycle to determine ovarian reserve. Since E2 can falsely suppress FSH, the interpretation of FSH requires that the E2 concentration be less than 40 pg/ml on same day.

An elevated FSH level does not necessarily mean that the woman is about to enter menopause. Rather, it suggests that she has entered the transitional period, which is the period that precedes the onset of menopause. Most women with increased FSH levels continue to have regular periods and ovulate. Women with markedly elevated FSH levels (greater than 20) usually do not respond adequately to stimulation with fertility medications and are best treated using donor eggs. This is even more indicated when raised FSH levels are detected in a woman over 40, whose egg quality is likely to be reduced as well.

It is important to realize that while FSH levels are relatively reliable indicators of ovarian strength and sensitivity to fertility hormones, it is largely the woman’s age that determines her inherent egg quality. While a woman in her 30s with a raised FSH is likely to have ovarian resistance to fertility drugs, the outcome may be better than someone in her 40s with normal FSH.

Women in the late reproductive years not only have significantly lower pregnancy chances, but also a high miscarriage rate due to chromosomal abnormalities in their embryos. IVF through facilitating the delivery of multiple embryos to the uterus can enhance the birthrate in such women. IVF is accordingly the treatment of choice for infertile women in their early forties, who simply do not have the time to waste on relatively non-efficacious alternatives. If conventional IVF fails using one’s own eggs, ovum donation promises outstanding success rates regardless of the woman’s age or FSH level. The live birth rate of ovum donations (regardless of the woman’s age) ranges from 50-55% per fresh cycle, not including the additional frozen cycle pregnancies.

Preparation tips for IVF

IVF treatment is beneficial for those who are experiencing infertility. Infertility is a term that is used to define the inability of a couple to conceive a baby naturally. This treatment is additionally known as In-Vitro Fertilization, so to get this treatment, you have to visit the IVF centers.

 

Here are certain ways to prepare your body for the IVF procedure.

• Eat fertility-enhancing foods
• Reduce stress
• Take your vitamins
• Improve sleep
• Quit smoking and drinking

Well, the preparation for IVF depends on the time. In this article, you will read how to prepare according to different time periods.

 

If You have 3 to 6 Months to Prepare for IVF

If you are planning to get IVF treatment after 3 or 6 months, then you have enough time to prepare your body for IVF. In addition to this, you will surely get the best results after the preparation of 3 months, because follicles or eggs take almost 3 months to mature. You may not know the quality of egg matters a lot, also give you positive results. In this time period, you have to talk to the doctor and get proper information about everything related to IVF preparation.

 

If You Have 1-2 Months to prepare for IVF treatment.

Quit smoking and drinking

If you are planning to undergo IVF within the next 2 months, then you have to stop smoking as well as limit your alcohol consumption. Since nicotine is too harmful to your ovaries and makes you unable to produce healthy eggs.

Take your vitamins

Along with this, you also need to take care of your nutrition too. You must take your vitamins properly for better and healthy pregnancy too. So, you must take high-quality prenatal supplements, these will help you to produce healthy eggs and will surely improve your body’s fertile environment. You have to start taking these supplements 2 months before trying to conceive a baby.

Must go with fertility improving foods

Yes, it is necessary to eat fertility-enhancing foods, so that you can simply conceive a baby without any problem. Essential foods include-:

• Royal jelly
• eggs
• sprouts
• fish roe
• seeds
• nettles
• nuts
• seaweed
• oats
• algae
• bone marrow
• caviar
• artichokes
• goji berries
• raw milk
• flax seeds
• oysters
• pollen

 

If You have only 2 Weeks to Prepare for IVF.

Improve sleep

In this condition, you have to take proper rest and sleep which contributes to sex hormones, ovulation, and sperm production too. Only adequate sleep matters a lot, so you have to take care of your sleeping habits.

Reduce stress

Taking too much stress may lead you to hormonal problems and makes you unable to produce healthy eggs. So, you must try breathing exercises, yoga, and meditation to reduce stress.

 

IVF preparation

WHO NEEDS IVF?

Although its original intention was to treat women with tubal disease, in-vitro fertilization (IVF) can help couples overcome various types of infertility. For some diagnoses or conditions, such as tubal factor, IVF may be the first-line treatment. In other cases, IVF may be recommended only if simpler treatment fails. Below is a list of common indications for IVF treatment:

Tubal Factor (Damage to Fallopian Tubes) / Pelvic Adhesions

There are two options to treat patients with significant tubal damage and/or pelvic adhesive disease. The first option is to surgically repair the tubes and either get pregnant naturally or use Artificial Insemination or IUI to get pregnant. In many cases, however, surgery is not a good option as it may be very difficult to surgically fix the damaged tube(s) and/or the surgery may cause a high risk of an ectopic pregnancy. In these instances where the surgical option does not pose a high chance for success, the second option is to by-pass the tubes completely by using IVF as the treatment plan. Advanced Fertility Care Physicians will individualize the treatment plan for each patient or couple at our Mesa, Scottsdale and Glendale AZ offices, and if you have tubal damage, they will provide you detailed information on each option so that you can make an informed decision.

Endometriosis

Current scientific data about endometriosis shows that mild to moderate forms of endometriosis may be effectively treated with a combination of surgical and medical therapy. For more stages of endometriosis, including the presence of endometriomas, IVF is the optimal first line treatment and offers the highest pregnancy success rates.

Male Factor Infertility

One of the most significant advances in the treatment of infertility has been the ability for men with severe sperm abnormalities to achieve fertilization of the egg and successful pregnancy. IVF with addition of ICSI (Intracytoplasmic Sperm Injection) has enabled couples suffering from abnormal sperm, who would not otherwise be able to conceive, to be able to start a family. ICSI is often recommended if there is any suggestion of a sperm problem, if sperm are obtained surgically, or if there has been a prior failure of fertilization.

Diminished Ovarian Function & Age Related Infertility

During the course of woman’s normal reproductive life, her ovarian function decreases with age. In many cases, this reduced function can be overcome through the use of IVF alone, or in conjunction with techniques such as Assisted Hatching and ICSI. For some women, this decrease in ovarian function may start at earlier ages and requires aggressive treatment with IVF sooner rather than later.

Anovulation & Polycystic Ovarian Syndrome (PCOS)

The majority of patients with an ovulation and/or PCOS often conceive using less aggressive treatments such as ovulation induction with IUI. For some patients who are “high responders” to gonadotropin therapy, IVF offers an excellent prognosis and reduces some of the risks of higher order multiples.

Unexplained Infertility

Approximately 20% of couples will have no identifiable cause of infertility after completing a comprehensive evaluation. IVF is often successful even if more conservative treatments have failed, especially since some of these couples may have yet unidentifiable causes of infertility or sub-fertility.

Family Balancing (also known as Gender or Sex Selection)

For families that wish to have additional children of a particular gender after already having a previous child, PGD allows for selection of embryos to transfer based on gender. While not perfect, embryo biopsy with genetic chromosome determination prior to transfer of embryos can allow families choice in how they expand the family. Read more about PGD.

Genetic Diseases / Preimplantation Genetic Screening or Diagnosis (PGS or PGD)

One additional indication for IVF is to provide genetic testing on embryos prior to implantation. PGD or PGS is used for patients who are at risk for passing on genetic disorders to their offspring as a result of one or both of the partners being carriers for the disease. Diseases such as Cystic fibrosis and Thalassemia are 2 examples of the hundreds of diseases that can be tested for prior to embryo implantation. In addition, IVF with PGS is indicated for women with recurrent pregnancy loss related to chromosomal abnormalities or repeated failed IVF attempts. Learn more about PGD.

What happens during IVF

IVF treatment involves 6 main stages:

1. suppressing your natural cycle – the menstrual cycle is suppressed with medication
2. boosting your egg supply – medication is used to encourage the ovaries to produce more eggs than usual
3. monitoring your progress and maturing your eggs – an ultrasound scan is carried out to check the development of the eggs, and medication is used to help them mature
4. collecting the eggs – a needle is inserted into the ovaries, via the vagina, to remove the eggs
5. fertilising the eggs – the eggs are mixed with the sperm for a few days to allow them to be fertilised
6. transferring the embryo(s) – 1 or 2 fertilised eggs (embryos) are placed into the womb

Once the embryo(s) has been transferred into your womb, you'll need to wait 2 weeks before taking a pregnancy test to see if the treatment has worked.

 

What happens during IVF

 

 

 

What Are The Costs of IVF?

The average cost of an IVF cycle in the U.S. is $12,400, according to the American Society of Reproductive Medicine. This price will vary depending on where you live, the amount of medications you're required to take, the number of IVF cycles you undergo, and the amount your insurance company will pay toward the procedure. You should thoroughly investigate your insurance company's coverage of IVF and ask for a written statement of your benefits. Although some states have enacted laws requiring insurance companies to cover at least some of the costs of infertility treatment, many states haven't .Costs-of-IVF

 

 

 The cost of IVF in Iran is more affordable than in other countries. Also, in Iran, the infertility treatment services such as IVF have a high quality in the region and in the world. The low-cost of IVF in Iran is due to the low doctors’ wages and inexpensive services in the clinic. The medications cost are the same all over the world. Learn more about IVF cost in Iran: The cost of IVF in Iran

 

Success Rates for IVF

Success rates for IVF depend on a number of factors, including the reason for infertility, where you're having the procedure done, and your age.

 

 

The CDC compiles national statistics for all assisted reproductive technology (ART) procedures performed in the U.S., including IVF, GIFT, and ZIFT, although IVF is by far the most common; it accounts for 99% of the procedures. The most recent report from 2016 found:

• Pregnancy was achieved in an average of 27.3% of all cycles (higher or lower depending on the age of the woman).
• The percentage of cycles that resulted in live births was 22.2% on average (higher or lower depending on the age of the woman).
   

Success Rates for IVF