Infertility profile (men)

What is infertility profile testing in men?

When a couple is unable to conceive a child even after having unprotected sexual intercourse for a year or longer, their condition is termed as infertility. In a significant percentage of such cases, the problem is related to male infertility.

Fertility depends mainly on the functioning of the hormones that are secreted by the glands like the thyroid and the pituitary and also by the reproductive organs. The infertility testing can be a complex and time-consuming process and requires the involvement of both partners to identify the cause and take the right steps towards a cure.

More than 35% of the problems associated with infertility are related to men and a lot of treatments for the same are available. The group of tests that for a part of the infertility profile testing for men includes a range of blood tests which are the same as the ones used in infertility profile testing for women. These include the following tests.

– Complete Blood Count (CBC)
– Erythrocyte Sedimentation Rate (ESR)
– Blood sugar tests.
– Vitamin B12, Vitamin D3
– Syphilis (VDRL)
– Hepatitis HbsAg

Apart from that, a few other tests are also conducted for men to check infertility which are listed below

– Sperm analysis includes sperm count, sperm quality and sperm morphology.
– Semen culture
– Testosterone test

What is the main causes behind the infertility profile testing in men?

In men, the problem of infertility can be caused by a number of factors, some of which are mentioned below.

– Erectile dysfunction is a common cause, affecting a large segment of men.
– Problems with sperm such as a low sperm count, poor sperm movement (motility) and abnormally shaped sperm.
– A hormonal imbalance.
– Enlarged veins around the testicles known as varicoceles.
– Abnormal obstructions that prevent sperm from being released during ejaculation.
– A mumps infection, which can cause inflammation of the testicles.
– Injury to one or both testicles that may result in pain or swelling.
– Acute illness or prolonged infections.
– Exposure of the testicles to excessive heat.
– Klinefelter syndrome is a condition resulting from the presence of two or more X chromosomes in a man.
– A groin, testicle, penis or scrotum surgery.
– Infertility can also be due to a combination of multiple factors and hence the right treatment is necessary when you are looking to conceive.

What are the main functions of the male reproductive hormones?

The three main hormones that play a significant role in the male reproductive system are the follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone.

In addition, the Gonadotropin-Releasing Hormone (GnRH) secreted by the hypothalamus also plays an important role. The most important role is played by testosterone which is produced by the Leydig (interstitial) cells of the testes and the rest is produced by adrenal glands. The production and the regulation of the flow of sperm is controlled by the combination of Testosterone and FSH. Low levels of testosterone can lead to low fertility, decrease in sex drive, poor erections, low sperm count and lower fertility.

The testosterone levels generally decrease at a rate of 1 % to 2% per year after the age of 40. The production of testosterone in the system is controlled by the LH hormone. The FSH hormone stimulates testicular growth and enhances the production of an androgen-binding protein which helps in the preservation of the growing sperm cells. It has also been found that FSH in combination with testosterone influences all the steps involved in the process of spermatogenesis.

The GnRH controls the production and the release of the LH and FSH from the pituitary gland.

How do I prepare for the infertility profile test?

The blood tests and the hormonal tests are simple and do not need any elaborate preparations. It is important to understand the details of the tests and their requirements from the doctor along with any restrictions that are needed. You should also inform the doctor about any sort of medication or over-the-counter medicines that you might be consuming as this might interfere with the test results. The doctors can also stop the consumption of any antibiotics that you might be consuming before the semen culture test.

What is the price of the infertility profile test for men in India ?

The price of the tests can range from Rs 3500 to 10000 depending on the facilities involved.

How is the infertility profile testing performed?

The blood and hormonal tests are performed by drawing a blood sample from a vein by inserting a needle which takes a few minutes. The method is known as venipuncture as it involves the puncturing of a vein. The blood collection method includes the following steps.

Initially, the skin around the collection site is disinfected by an antiseptic solution. In most cases, a vein from the elbow region is chosen. Sometimes a vein can also be chosen from the back of the hand.

An elastic band is tied around the upper arm to make the veins swell up with blood. This makes the veins more visible and the collection process easier.A needle is inserted in the vein to draw the blood into a connected syringe.

The elastic band is taken off and the needle is pulled out from the skin. Slight pressure is applied to the site for some time to prevent any excess bleeding. It is then covered with a bandage.

In case of semen analysis, a sample of the semen is collected in a sterile container through self-stimulation and the necessary testing is conducted on the sample. The sperm sample is to be kept at body temperature and should not be left at room temperature or refrigerated.

When will I get the test results?

The result of all the tests is generally delivered within 2 to 3 days though it can get delayed under specific circumstances.

What is the significance of the Syphilis (VDRL) test?

Sexually transmitted diseases like syphilis are very common in the world and complications resulting from the same can affect male fertility. Congenital or tertiary syphilis can affect the cells in the testes and also damage the local tissues. This can affect testicular function and overall fertility.

Other side effects of the disease can also cause erectile dysfunctions. In many cases, the psychological impact of this disease can also have an adverse impact on male sexual function and fertility. The more severe effects of syphilis, if left untreated, is on the health of the pregnancy and the new-born.

What role does semen analysis play in infertility?

The role of mature and healthy sperms that can move efficiently is very important in male fertility. While some problems related to sperm can be from birth, other problems can be related to lifestyle issues like smoking, drinking alcohol and consuming certain medications.

A certain percentage of men also have blockages in the sperm pathway that can lead to infertility. While sperm volume, count, concentration and movement are measured in the test, in some cases, the lack of the right sugar levels in sperm can also be an issue. It is to be noted that even if the tests indicate a low sperm count, it does not mean that the patient is permanently infertile.

What is measured in semen culture?

The semen culture test checks the semen for the presence of some common pathogenic microorganisms including bacteria. The test is also used if there are symptoms like painful ejaculation or the presence of blood in semen. If there are multiple strains of microorganisms present in the sample, it generally means that the sample was contaminated and a repeat test is necessary.

What are the reference ranges for the infertility profile test for men?

The normal sperm count for healthy males can range between 15 million sperm to more than 200 million sperm per milliliter of semen. Values less than 15 million sperms in a millilitre is considered as a low count. The reference hormonal levels in adult males are mentioned in the table below.

What are the risks involved with the infertility profile test ?

The blood tests are simple in nature and are generally free from risks. Since the size of the veins varies in patients, multiple punctures may be needed in patients in whom the veins are hard to detect. In some cases, a patient might feel dizzy or lightheaded due to loss of blood after the collection and may need proper care.

In most cases, any pain or bruising in and around the collection site is generally cured within a few days. Chances of infection or excess bleeding are rare but might happen in some cases and such scenarios demand proper medical attention.