Mysuru Fertility Centre

Semen analysis

Semen analysis, also known as spermiogram, is the first test performed to know the fertility status of a man. Semen is the fluid containing sperm that’s released during ejaculation. A semen analysis measures three major parameters

• the number of sperm
• the shape of the sperm
• the movement of the sperm, also known as “sperm motility”

A semen analysis is recommended when couples are having problems getting pregnant. The test will help determine man’s fertility status. The analysis will also help determine if low sperm count, poor motility and abnormal morphology or sperm dysfunction is the reason behind infertility.

The Hypo osmotic Swelling (HOS) test

The hypo osmotic swelling (HOS) test evaluates the functional integrity of the sperm’s plasma membrane and serves as a useful indicator of its fertility potential. The functional integrity can be demonstrated by allowing sperm to react in a hypo osmotic medium. The hypo osmotic swelling test indicates that only cells with intact membranes (live cells) will swell in hypotonic solutions. Spermatozoa with intact membranes swell within 5 min in hypo osmotic medium, and all flagellar shapes are stabilized in 30 min.

Follicle Stimulating Hormone

The production and release of follicle stimulating hormone is regulated by the levels of several circulating hormones released by the ovaries. Most often, raised levels of follicle stimulating hormone are a sign of malfunction in the ovary. If the gonads fail to create enough oestrogen, testosterone and/or inhibin, the correct feedback control of follicle stimulating hormone production from the pituitary gland is lost and the levels of both follicle stimulating hormone and luteinising hormone will rise. This condition is called hypergonadotropic-hypogonadism and is associated with primary ovarian failure or testicular failure. Checking for the level of FSH in the blood will indicate the function of the ovary.

Forward Progressive Motility Test

A sperm that zigzags but makes forward progression would be considered progressive. Progressive motility is needed for the sperm to swim their way up the female reproductive tract. Total motility refers to the percentage of sperm making any sort of movement.

Testicular Epididymal Sperm Aspiration

Many azoospermic patients (no sperms in the ejaculate) with nonobstructive azoospermia (NOA) might be candidates for sperm aspiration as part of their in vitro fertilization procedure. Because sperm might be present in some but not all parts of the testes of such men, multiple samplings of the testicular tissue are usually performed to increase the probability of finding sperm. These samplings can be done by 2 methods:

1. TESE (testicular sperm extraction), which is a surgical biopsy of the testis; or
2. TESA (testicular sperm aspiration), which is performed by sticking a needle in the testis and aspirating fluid and tissue with negative pressure.

Hyaluronan Binding Assay

Hyaluronan has recently been employed in the development of a commercial diagnostic kit for assessing sperm maturity and DNA fragmentation, the sperm-hyaluronan-binding assay (HBA).

Sperm DNA Fragmentation Assessment

The integrity of genetic material in the sperm is crucial for successful fertilisation and normal embryo development. Sperm DNA fragmentation is a term used to denote abnormal genetic material within the sperm, which in turn may lead to male subfertility, IVF failure and miscarriage. A conventional semen analysis done for sperm concentration, motility analysis and morphology assessment cannot assess the sperm at the molecular level and as result aid the detection of DNA fragmentation.

Sperm Morphology Predictive Assessment

Sperm morphology, the size and shape of sperm is one factor that's examined as part of a semen analysis to evaluate male infertility. Sperm morphology results are reported as the percentage of sperm that appear normal when semen is viewed under a microscope.

Normal sperm have an oval head with a long tail. Abnormal sperm have head or tail defects such as a large or misshapen head or a crooked or double tail. These defects might affect the ability of the sperm to reach and penetrate an egg.

Percutaneous Epididymal Sperm Aspiration (PESA)

Percutaneous Epididymal Sperm Aspiration (PESA) does not require a surgical incision. A small needle is passed directly into the head of the epididymis through the scrotal skin and fluid is aspirated. The embryologist retrieves the sperm cells from the fluid and prepares them for injection into the egg,ICSI.

Hysteroscopy

Hysteroscopy is a procedure that allows to look inside the uterus to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.

Anti-Mullerian Hormone

Anti-Mullerian Hormone (AMH) is a hormone secreted by cells in developing egg sacs (follicles). The level of AMH in a woman's blood is generally an indicator of her ovarian reserve. AMH does not change during menstrual cycle, so the blood sample can be taken at any time of the month.

Tubal Patency Test

Tubal patency is when a woman's fallopian tubes are not blocked. Tubal patency is determined by an x-ray test called a hystero-(uterus)salpingo-(fallopian tube)graphy (HSG). HSG is a standard radiological imaging study that is used to determine if the fallopian tubes are open and free of disease. SSG (Sono salpingography) is newer addition to determine the patency at MFC with more precision and accuracy.

Ultrasound Scans

An ultrasound scan uses high-frequency sound waves to capture live images from the inside the body. It’s also known as sonography. An ultrasound allows to see problems with uterus without needing to make an incision. Unlike other imaging techniques, ultrasound uses no radiation. For this reason, it’s the preferred method for viewing a developing foetus during pregnancy.

3D Saline Ultrasound sonography

Saline infusion sonohysterography (SIS) or saline ultrasound uterine scan uses a small amount of saline (salt solution) inserted into the uterus (or womb) that allows the lining of the uterus (endometrium) to be clearly seen on an ultrasound scan.

“Ultrasound” is the term used for creating pictures or images using high-frequency soundwaves. The pictures are obtained using an ultrasound transducer. Ultrasound transducers transmit high-frequency sound waves that are converted into electrical impulses that produce a moving image of the inside of the body on a screen.