Infertility affects nearly 15% of couples, and amongst them, about 25% of infertility is directly due to the male partner, and another 15 to 25% of the cases have something to do with the man. So it is necessary to take semen analysis to be able to treat infertility as soon as possible, and in the most effective way. After being diagnosed, your choice of medical destination and the type of treatment you’ll receive play an important role in your chance of having a baby. That's why Iranian hospital personnel makes sure your treatment procedure is done in the best way possible and you’re satisfied with infertility treatment in Iran. IVF in Iran is also a very common and safe alternative to becoming parents.
Male Reproductive System
Seminiferous tubules are long, densely packed tubes in the testis that produce sperm. The ends of each tubule connect to an area known as the "rete testis," which leads to the epididymis. The epididymis is a single, tightly coiled tube in which sperms mature. The epididymis connects to the vas deferens, which are responsible for transporting the sperms.
Testis And Epididymis
The testis must be 2-3 Celsius degrees cooler than the core body temperature to produce sperm. The male reproductive system is also designed to keep sperm away from immune system cells, which would otherwise recognize the sperm as "foreign" and produce antibodies against it. If the testis is physically damaged or sperm leaks from the wound after a vasectomy, this barrier may be broken.
The testis not only produces sperm but also the male sex hormone testosterone. During puberty, testosterone levels rise, causing the genitals, seminal vesicles, and prostate to develop. As a result of these developments, body hair and beard grow, and muscles associated with the male physique develop.
Two hormones from the pituitary gland at the base of the brain stimulate sperm and testosterone production – luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
the Fluid from the epididymis (about 5% of total volume), the prostate (30%), and the seminal vesicle (65% of total volume) are mixed during ejaculation. Semen changes to a semi-solid state shortly after ejaculation due to components in the seminal vesicle fluid. After about 20 minutes, enzymes in the sperm make it liquid again.
Male Fertility Tests
Different tests can tell us about the fertility state of a man such as blood tests, yet the most common test is semen analysis.
In this analysis, the doctor checks testes sizes, the genitals development, their consistency, hair patterns, and whether there is any sign of varicocele present. The hair patterns indicate testosterone production. A varicocele is characterized by the presence of "varicose" veins in the blood vessels that supply the testis and can be felt but are rarely seen.
FSH and testosterone levels are measured by this test. A high FSH level indicates that the pituitary gland is attempting to stimulate sperm production but the testes are not responding adequately. Low testosterone levels can impair sperm production and male sexual drive.
A karyotype is a test that detects chromosome abnormalities that may lead to male infertility. For example, a man may have extra chromosomes:XXXY instead of XY. This abnormality can affect a man’s fertility.
Nearly 10% of men suffering from producing so few or no sperm lack a tiny piece of the Y chromosome called Y chromosome microdeletion. This deletion can occur in three different subregions on the male Y chromosome: AZFa, AZFb, and AZFc. Detecting exactly in which area this has happened can inform your doctor about the existence of sperms in the testis and whether a testicular biopsy can be resultful.
In the majority of cases of male infertility, abnormal sperm analysis results are observed. The initial evaluation, at the very least, should include a properly performed sperm analysis. If an abnormal result is obtained, additional sampling should be performed after at least 4 weeks. It should be noted that sperm parameters can vary greatly over time, as a result of temporal and seasonal changes even in men with no fertility problems. Having this in mind, to obtain a more accurate result, performing more than one examination in the evaluation of sperm analysis is crucial.
If there is no complaint or suspicion of sexual dysfunction, the presence of a normal sperm analysis will often ensure that an important male infertility factor is ruled out. In contrast, obtaining abnormal sperm analysis results will necessitate additional endocrinological, urological, and genetic studies. Also, it is good to notice that in this test the volume of the semen, the sperm counts, and the sperm motility are measured.
For a more accurate result, the semen must be collected after 2 to 7 days of sexual abstinence. The best way to collect the semen is by masturbating in a special container. You need to keep in mind that all the semen ejaculated must be kept. Before the process, hands and genitals should be washed and you cannot use soap or other lubricants during the masturbation. It’s also important to feel comfortable in that environment, because stress and tension may negatively affect the semen parameters.
Checking the shape of the semen is needed when it comes to deciding which treatment can be offered. Otherwise, it cannot help with diagnosing infertility.
Sperm Antibodies can reduce the chance or prevent sperm from fertilizing an egg, as well as decrease sperm movement in a woman's cervical mucus. Doctors use a screening test called the 'SpermMar,' in which antibodies in sperm bind to tiny plastic beads. More than 40% binding is generally regarded as significant, though lower levels may be important following vasectomy or vasectomy reversal.
The difference between sperms and other cells is that sperms don’t have an efficient DNA repair system and if they are to fertilize an egg they must use all their DNA parts. This test is more valid than the others because it measures thousands of sperms at once. And just like other tests, this one also doesn't give you a black and white result. consequently, the higher the amount of DNA damage, the less is your chance of pregnancy. DNA damage from 10% to 30% indicates that you may be able to be fertile but it is not very likely and when the damage is higher than 30% means the chance of pregnancy in treatment is also low.
After getting the result of your sperm analysis, your doctor can guide you through treatment options such as IVF in Iran, or more common infertility treatments in Iran.