When infertility is a man issue

‘The percentage of patients with man infertility is considerable’

Man infertility is deemed to exist when, after a year of unprotected sexual intercourse without conceiving a child, a complete test of the couple reveals that the causes of infertility are attributable to the man.

Nowadays, what has always been a taboo subject for males is being normalised, since it has been found that the percentage of male infertility is comparable to that of females. Despite the current openness and the attempts to raise the general awareness about this, there is still much misinformation on the subject.

Today we are meeting with Laura Van Os, embryologist in IVF Spain, who can offer us a further insight into man infertility and the solutions that reproductive medicine offers to it.

male infertility

How many patients are unaware of the fact that their fertility problem may be caused, whether partly or completely, by a male factor?

The percentage of couples where a male factor plays a role in their infertility problem is considerable.

Sometimes there are men who come to our clinic with a history of failed cycles where the egg quality appeared to be good. This makes us suspect that there might be something wrong with the sperm. When the sperm sample is analysed in depth, sometimes it turns out that there is a molecular problem in it, which is causing their infertility.

We also know this out of experience with patients who undergo egg cell donation programs. There is a concrete set of donors, with proven fertility, from whom we are certain that we can expect good results. However, when we fertilize their eggs with these presumably defective sperm samples, we may find that they yield considerably poorer results than expected.

What is the difference between a standard sperm test and the advanced sperm test that IVF Spain offers?

In a standard spermiogram, the basic analysis carried out in all andrology units, the concentration, motility and shape of the sperm cells are checked. This gives us a first insight into the quality of the sperm. In an advanced spermiogram we go one step further and we also test the molecular properties of the sperm. We do not just check the outer appearance of the sperm cells but also their inner content.

What other aspects of the sperm are checked in an advanced sperm test?

In an advanced sperm test we check the DNA fragmentation and the apoptosis. These are tests that are carried out through flow-cytometry. The DNA fragmentation of the sperm cells measures the damage in the genetic core of the cells. High fragmentation values indicate that the ability of the sperm cells to successfully fertilise an egg cell is compromised. The apoptosis measures the vitality of the sperm cells. In the case that there is a high percentage of apoptotic sperm cells, these cells need to be removed from the sample before the fertilization is induced.

What impact does this have on achieving a pregnancy?

When the results of the molecular tests show that the sample is altered, there are specific techniques that we can use in the laboratory to select the right sperm cells, the ones that are not molecularly damaged, for the fertilisation, and we can therefore improve fertilisation rates. By improving the fertilisation rates we are also improving the cycle’s outcome.