Male Infertility Testing
What are advanced semen tests and why are they recommended?
A basic semen analysis may be done to learn if a man is infertile (unable to father a child). Sometimes a basic semen analysis does not provide all the information your doctor needs to diagnose and treat infertility. Your doctor may recommend more specialized tests; these tests are frequently referred to as “advanced semen tests.” The most common of these tests examine the semen for reactive oxygen species, total antioxidant capacity, and damage to the genetic material (DNA) contained within the sperm.
What is a semen profile?
A basic semen analysis combined with advanced semen testing is known as a semen profile.
What are reactive oxygen species?
Reactive oxygen species (ROS) are also called free radicals. When present in large amounts, ROS may damage the sperm and the DNA within the sperm. This damage may lower the chances of pregnancy.
Why is an ROS test ordered?
There may be many reasons why your doctor recommends a ROS tests. Common reasons for this test include:
- a high number of white blood cells in the semen
- varicocele (the veins coming from the testicle are dilated, or widened, because of a problem with the valves that control the flow of blood from the testicles to the body)
- history of spinal cord injury
- unexplained infertility
What can I do to lower the levels of ROS?
If your doctor thinks you might have an infection, he or she may recommend additional tests and/or prescribe a course of antibiotics. If you have a varicocele, your doctor may recommend a procedure to fix it. In many cases, the doctor will recommend you consume more antioxidants in your diet. This can be done by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants.
What is the total antioxidant capacity test?
The total antioxidant capacity (TAC) test measures the amount of antioxidants in the semen. Antioxidants in the semen are believed to protect the sperm by cancelling out the harmful effects of reactive oxygen species.
What are the reasons to order a TAC test?
The TAC test is typically ordered with the ROS test. Together, the two tests can show how likely the sperm are to be damaged by ROS.
What can I do to increase the levels of antioxidants?
In many cases, the doctor will recommend you consume more antioxidants in your diet. This can be done by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants.
What is a DNA fragmentary index?
DNA contains our genetic blueprint. The DNA fragmentary index (DFI) test compares the number of sperm with broken DNA strands to the total number of sperm in a man’s semen.
Because sperm with broken DNA can look the same as healthier sperm, the percentage of sperm with broken DNA cannot be determined by a basic semen analysis. Every man has sperm with damaged DNA, but men who have a higher percentage of damaged sperm may have a harder time creating a pregnancy. Therefore, if your DFI is high, your doctor may recommend a treatment to try to reduce the DFI or may recommend a change to your reproductive treatment plan.
What are the reasons to order a DFI?
There may be many reasons your doctor may recommend a DFI test. The most common reasons are:
- unexplained infertility
- lack of pregnancy after multiple attempts
Please note that a DFI test may not be possible in men who have a very low number of sperm in the semen.
What can I do to lower my DFI?
There are several suggestions for lowering the DFI:
- Men with a high DFI should stop using all tobacco products and all recreational and/or illicit drugs, as these substances are believed to damage sperm DNA.
- If you have a varicocele, your doctor may recommend it be fixed.
- If your ROS is elevated, your doctor may recommend you consume more antioxidants by eating a diet rich in fresh fruits and vegetables or by taking a nutritional supplement that includes antioxidants.
If your doctor recommends an intervention, such as those mentioned above, it is usually appropriate to repeat the DFI test several months after treatment.
How long does it take to complete advanced semen testing?
Once the semen sample is submitted, it typically takes 2 to 3 days to complete the ROS test and 2 to 3 weeks to complete the TAC and DNA tests. Once the tests are completed, your fertility team will review the results with you.
- U.S. National Library of Medicine. Genetics Home Reference. Reactive oxygen species Accessed 6/12/2013.
- Sharma RK, Pasqualotto FF, Nelson DR, et al. The reactive oxygen species—total antioxidant capacity score is a new measure of oxidative stress to predict male infertility. Hum Reprod (1999) 14 (11): 2801-2807.
- Pahune PP, Choudhari AR, Muley PA. The total antioxidant power of semen and its correlation with the fertility potential of human male subjects. J Clin Diag Research. 2013 June Vol-7(6): 991-995.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/14/2013…#15237