Diagnosing Infertility Infertility is usually thought to be a concern when a couple is unable to get pregnant after a year of unprotected intercourse. Our job is to find out why you are having trouble conceiving. Gyft Clinic has a streamlined process for diagnosing infertility. Once we have a clear diagnosis, we can provide you with the most effective and efficient treatment options available to help you conceive. Diagnosing infertility is the first step to potentially having a child. Let's briefly discuss the types of infertility. Types of InfertilityThere are two types of infertility. Primary infertility is where a couple is having trouble conceiving and has never had a baby. Secondary infertility means a couple is unable to become pregnant after already having a baby. Infertility is probably more common than you think. Approximately 8% of couples have trouble conceiving. Although that doesn't seem like a terribly high number, many couples assume they won't fall into this minority and decide to put off trying conceive until later in life when they tend to be more financially and emotionally secure. Just be careful not to take having children for granted. For most, the longer you wait the more difficult it becomes to conceive. There are several physiological steps needed for a successful pregnancy and a disturbance in any of the steps can cause varying degrees of infertility. It may help you to learn about the reproductive process. By doing so, couples can learn to decide when and if it's time to get a doctor's help to correct any potential problems. If you are already struggling with infertility, help is just a phone call away. Gyft Clinic infertility specialists can accurately diagnose and treat your problem with many treatments readily available to help you. Infertility Treatment ProcessLearning about infertility for the first time can be intimidating. If you've had no progress at other fertility clinics you may be frustrated. Here, you'll learn how we plan on helping you to conceive. Our goal is to help you become comfortable with the infertility treatment process. Understanding how we can help will hopefully alleviate any stress or frustration you may be feeling in dealing with an infertility problem.  Registration: On your first visit, you'll be warmly greeted by one of our receptionists. You and your partner will check in and fill out some patient information and history forms. Alternatively, you can download these forms in advance and have them completed before you arrive, saving you a bit of time in the waiting room. Paperwork: You can view and download the patient information and history forms by clicking here. Please arrive at least 15 minutes before your appointment if you plan on completing your paperwork here in the office. You may also be asked to send copies of any relevant medical records from your primary physician before your appointment. Medical records release forms can be downloaded here. To get your records, fill out the form and fax or mail it to your current doctor's office at least two weeks before your appointment to be sure that we have them before you arrive. Doctor Consultation: You'll be scheduled to consult with one of our physicians, Dr. Robert Mc Lees or Dr. Luis Murrain. Learn more about them on our "Staff" page. They'll spend approximately 30 minutes listening to your concerns and discussing your history. Your doctor will provide information on diagnosing potential problems and which treatment options might be most suitable to your particular situation. Your doctor will gain valuable information during this consultation. Some information will come from you, some from your medical history and some from new testing your Gyft doctor will likely request. Once he has all relevant information, he can develop a treatment plan specific to your situation. We usually start with what we call a "work up" cycle to determine your general fertility status. We're able to find a cause in approximately 85% of infertile couples we see. For approximately 15% of couples, no specific reason for infertility is found. In these cases, more specific tests may be necessary. Testing may be done in any of five major areas of infertility. The source of your infertility is likely to be found in one of these areas.
Your doctor will look at each category as it relates to your situation. Five Reasons for Infertility These five reasons will help you understand what can cause male and female infertility. Behavioral and Chemical Factors Lifestyle behaviors can affect your fertility. Your body needs to be in balance with your reproductive system. When this balance is interrupted, infertility can be a result. Some factors that can cause problems include poor nutrition, hormonal imbalance, drug use or stress. Your doctor will want to discuss if any of these issues are affecting you. Be open and honest with your answers. Knowing everything that may be adversely affecting your ability to conceive will help us minimize or eliminate them entirely. Nutrition, exercise, smoking, and drug or alcohol intake may impact your ability to conceive. There are a number of medications, including some used to treat ulcers, heart conditions, high blood pressure, and cancer that can influence sperm count and/or sex drive. Some medications are known to impair fertility and your physician may be able to recommend alternative medications. Drugs such as marijuana, anabolic steroids and cocaine can cause profound, sometimes irreversible decreases in sperm production in chronic users. There are a number of lubricants, if used during intercourse, that can affect sperm quality. Your infertility doctor should be able to recommend a lubricant that won't interfere with conception. If you are at high risk or have a history of sexually transmitted diseases (STDs), you may have a higher potential for infertility as well as putting your partner's and potential child's health at risk. Several types of infertility can be directly linked to the presence or past exposure to a sexually transmitted disease. Your doctor may recommend a panel of STD blood tests. They would be performed on you and your spouse to verify the presence or absence of any diseases that may be impacting your fertility. Even if you don't believe you have been exposed or show any symptoms of exposure, it is still possible to be a carrier. Click here to learn about the symptoms and dangers of some of the most common sexually transmitted diseases. You are encouraged to discuss any of these behaviors with your doctor openly. If any of them are affecting you, we can help. There are ways they can be controlled or regulated. This will improve your overall health and maximize your chances of pregnancy. Ovulatory Cycle In order for a woman to conceive, her ovary must be able to produce a healthy egg and ovulate it at regular intervals. The process is called an ovulatory cycle. To complete the ovulatory cycle, the female reproductive system must produce adequate amounts of certain hormones. Learn more under "Ovarian Physiology". Ovulatory disorders commonly cause infertility in women. Your doctor will want to discuss the frequency and nature of your menstrual cycles. Any irregularities in your cycle history may give your doctor insight into a hidden problem. Your doctor may request blood tests to deny or confirm any suspicions he has. Hypothalamic-Pituitary Disorders Some women fail to ovulate because there is little or no stimulation coming from the pituitary gland. This is common in women who exercise vigorously. Other causes may include stress, anorexia or related eating disorders. You need to make a sufficient amount of FSH to induce any of the follicles in the ovaries to begin development. Blood tests can verify the presence or lack of FSH. If FSH is absent or very low, options are available. It can be treated by stimulating the pituitary gland to release more FSH. Another option is to replace the missing FSH by injecting it into your body. See "Injectable Gonadotropins" for more information. Premature Ovarian Failure Women who fail to ovulate may do so because they have very few, or no eggs left in their ovaries. When this happens before the age of 40, it's called "premature ovarian failure" or "early menopause." Sometimes there's no obvious explanation as to why there's a low supply of eggs. It's possible some women waste eggs by the thousands instead of hundreds each cycle. This can cause them to run out sooner than women with a normal egg supply. Or it might be that some women just have fewer eggs to begin with. Learn more under "Ovarian Physiology". A woman with no eggs cannot bear children. It doesn't matter how much her ovaries are stimulated with fertility medications. This doesn't mean she can't become a mother, however. Please see "Egg Donation" and "Gestational Hosting". Premature ovarian failure can be detected with a blood test. It's indicated with irreversibly high levels of FSH in the blood stream. Pregnancy and Age  As a woman approaches 40 and older, her chance of becoming pregnant decreases, typcially as a result of a lower fertility potential. Nationwide statistics show a dramatic decrease in pregnancy rates in women 40 years and older. The decrease happens even when using the most advanced infertility treatments. These stats don't preclude a woman from becoming pregnant after 40, but are a warning to start trying to have children at an earlier age, preferably 35 and younger for the best outcomes. Attempting to conceive at a younger age gives couples time to get help from an infertility doctor if they find out they're having trouble on their own. Again, if there is one piece of advice we'd give a couple who knows they want children together - START EARLY! Unlike men, women have a much quicker biological clock that typcially begins winding down in their thirties. Conversely, men can often be expected to produce sperm their entire lives. Is your husband or partner putting off having a child? Educate them on the risks of waiting too long. Polycystic Ovarian DiseaseMost women who don't ovulate regularly have two things in their favor. They 1) usually have a functional pituitary gland, and 2) still have plenty of egg-containing follicles in their ovaries. The problem might be that there's a hormone imbalance between the FSH released from the pituitary and the subsequent estrogen response of the follicles. The specific source of the problem can vary and the source isn't known for some patients. But many of these women will have clinical signs of Polycystic Ovarian Disease. Polycystic Ovarian Disease involves the presence of many small follicles within the ovary. It's usually due to a lack of sufficient FSH stimulation that prevents the follicles from developing to maturity. We explain this more in "Ovarian Physiology". Proper FSH levels are necessary to promote the maturation of one or more of these follicles to ovulation. Inadequate FSH levels can halt the development of a dominant follicle. It also leaves the ovary full of many immature follicles incapable of ovulating. Polycystic Ovarian Syndrome can be detected using an ultrasound to visually check for follicles in the ovary, and from abnormal levels of FSH in the blood stream. Treatment usually focuses on raising FSH levels to promote follicular growth and development. When properly treated, the result is the release of a healthy, mature egg. Please see "Clomiphene Citrate" or "Injectable Gonadotropins" under Ovulation Induction. Detecting Hormone Imbalances Virtually every hormone affecting fertility can be measured directly in the blood. We believe it's the most reliable way of confirming whether or not a particular hormone is present in the body at appropriate levels. Some hormone levels vary dramatically during a menstrual cycle. That's why it's important to have them measured at the right time of the cycle in order to be interpreted correctly. From the illustration above, you can see there are three distinct phases associated with the menstrual cycle. These include the Follicular Phase, Ovulatory Phase and Luteal Phase. Follicular Phase: The portion of the cycle from the start of menstruation up to ovulation. Ovulatory Phase: The portion of the cycle just before and after ovulation. Luteal Phase: The portion of the cycle after ovulation and up to menstruation. Estradiol is the primary estrogen we measure in the blood stream. Estradiol and progesterone levels can be different depending on the phase of the cycle. This makes timing of the blood tests important. FSH and LH are more or less constant. The exception is around the time of ovulation. Estradiol: It's secreted by developing follicles in response to the presence of FSH in the body. Please see "Ovarian Physiology" for more information. The more mature or the higher the number of follicles, the more estradiol is detectable in the blood. Estradiol levels increase as ovulation approaches. They decline slightly during ovulation. The levels rise again in conjunction with progesterone levels. This is done to prepare the endometrium for possible conception. The endometrium thickens as the cycle goes on. Even though FSH is the hormone causing a follicle to develop, we usually don't measure FSH except at the beginning of the cycle. This is because the amount of FSH during the cycle is not that important. We need to look at the affect of FSH on the ovary by measuring the estradiol level. Normal follicular development is reflected in increasing estradiol production until the time of ovulation. It's normal to have your estradiol level checked at the beginning of the cycle to insure levels are appropriately low. During the follicular phase, subsequent estradiol tests are done to be sure your levels are rising adequately, hopefully in conjunction with maturing follicles. FSH: As discussed elsewhere, FSH is a hormone produced by the pituitary gland. FSH stimulates the ovary to begin follicular development. It usually doesn't increase during a normal ovulatory cycle. This is because the presence of estradiol in the follicular phase restricts the production of more FSH. FSH is more important to measure once every few cycles to check for the onset of ovarian failure. Ovarian failure is the inability of the ovaries to produce egg-containing follicles. Follicles produce estradiol and the presence of estradiol keeps FSH levels low. The lack of estradiol from having no follicular growth causes the pituitary gland to keep producing higher levels of FSH. It does this to try and stimulate the ovaries to function. Thus, the higher the circulating FSH level, the more difficult it is to stimulate the ovaries to mature and release eggs. Rises in serum FSH levels to the point where ovarian failure is indicated happens over time. The time frame can be from a few months to many years. Once FSH levels rise they typically don't come back down. We periodically check your baseline FSH levels. Doing this allows us to foresee potential ovarian resistance or failure. From there we get more aggressive with treatment as time becomes a factor. Progesterone: Progesterone is a hormone secreted by the corpus luteum following ovulation. Progesterone is carried by the blood to the uterus. With estrogen, progesterone helps prepare the uterus for possible conception. In pregnancy, progesterone protects the implanted embryo and fosters growth of the placenta. It does this by working to decrease the frequency of uterine contractions which might otherwise result in the expulsion of an ongoing pregnancy. Inadequate levels of progesterone can cause problems with menstruation and conception in non-pregnant women and spontaneous abortion or miscarriage in pregnant women. But there is an easy fix. There are several methods of supplementing your body with progesterone when natural levels prove inadequate. Progesterone supplementation is routinely given to our newly pregnant patients as a preventative measure against early miscarriage. Prolactin: Prolactin is a hormone secreted by the pituitary gland and is normally present in low levels in non-pregnant women. High levels of prolactin can cause anovulation, but can be lowered with proper medication to levels where normal ovulatory cycles can resume or at least allow for better response from ovulation induction methods.  Thyroid Disorders: Thyroid disorders are a result of problems with the thyroid gland and can impair a woman's ability to ovulate. Appropriate replacement of thyroid hormone can correct these problems. Your doctor may decide to have one or all of your hormones checked. Testing of your hormones will often happen during your work-up cycle. Because hormones can fluctuate during a cycle, you may be instructed to have your blood drawn on particular days of the cycle. Please be prepared to follow a strict schedule for any blood draw appointments. Test results give your doctor an accurate picture of how your hormones are performing during your cycle. Luteinizing Hormone (LH): We commonly refer to this hormone as LH. It's an important part of the reproductive endocrine system but is a hormone we no longer find necessary to perform blood tests on. LH's primary role in the reproductive process is to trigger the follicle to release its egg and occurs as a sharp increase, or surge, in the level of LH at the midpoint of the ovulatory cycle. The actual value of LH in the blood is not important for testing. We want to know if the LH surge is taking place. Ovulation predictor kits can detect an LH surge reliably and cost less than a blood test. For many infertility treatment regimens, the LH surge becomes irrelevant. We have the means to control the time of ovulation ourselves using certain medications. This can be important since the LH surge may happen at inopportune times or the surge may not happen at all if left to the body's discretion. HCG: HCG is a "surrogate" LH. It has the same stimulatory effects on the ovary that LH does. HCG can be given by injection to trigger ovulation at the right time in the cycle as determined by your doctor. In some cases, it may be desirable to shutdown your body's production of LH and FSH altogether. Please see "GnRH Analogues" under Injectable Gonadotropins for indications. Anatomical FactorsInfertility can also be caused by problems with the anatomy of the female reproductive system. Many common anatomical factors are associated with tubal, uterine and pelvic abnormalities. These problems may be genetic or the result of disease, injury or past surgical procedures. Anatomical factors are important to diagnose. Even if they can't always be repaired, treatment can be tailored to work around the problem areas. Tubal FactorsTubal factors involve any blockage or damage to the fallopian tube that prevents an egg, once ovulated, from reaching the uterus. Tubal factors are among the most common anatomical factors causing infertility. They may be a result of current or past infection from sexually transmitted diseases (chlamydia and gonorrhea being two of the most common), endometriosis, or appendicitis. They may be a result of a prior surgical procedure that caused pelvic adhesions or scar tissue. There could be damage from birth control methods such as IUD use or tubal ligation. Women with tubal factors are at a higher risk for having an ectopic pregnancy. This is because damaged or blocked tubes can prevent an egg from getting through the tube to the uterus, but may not prevent sperm from reaching the egg and fertilizing it thereby leaving the growing embryo trapped in the tube. Tubal damage can be irreversible, but can be surgically repaired in some less severe cases. Your infertility doctor will be able to determine the extent of any tubal damage. He'll determine if the tubes can be surgically restored. One way to diagnose a tubal factor is with a Hysterosalpingogram, or HSG. Here's how it works: Your doctor or referred radiologist injects a liquid dye (which is visible on x-ray) into the part of the tube connecting to the uterus. They see if the fluid is able to freely spill through to the opposite end of the tube, near the ovary. If not, a blockage of some kind is usually the problem. Your doctor will determine whether or not it can or should be removed. In some cases flushing dye through the tubes during the HSG is enough to clear minor blockages and restore fertility. Depending on the results of the HSG and/or your medical history, your doctor may wish to perform a surgical evaluation of the fallopian tubes and the other reproductive organs called a laparoscopy. You can still get pregnant regardless of the tubal damage or obstruction. You can become pregnant with one or no functional fallopian tubes. Women with one functional tube can only conceive when an egg ovulates from the ovary near the good tube. Ovaries often alternate the release of an egg from one cycle to the next. One month the left ovary releases an egg, the next month the right ovary releases an egg. If one tube is damaged or blocked the chance of pregnancy still exists but will be less than a woman with two functional tubes, because an egg is only made available every other cycle. Ovulation Induction is one way we can force each ovary to produce eggs every cycle. This increases your chance of becoming pregnant. In cases with no functional tubes, the only option is In-Vitro Fertilization (IVF). Please see the "ART" section for details. With IVF, eggs are taken directly from your ovaries. They're placed in a dish with your partner's sperm. They're allowed to develop to embryos. The embryos are transferred back to the client's uterus a few days later. With IVF, the tubes are completely bypassed. They can be damaged, blocked, or even completely absent but they won't factor into the outcome of the procedure. IVF has a higher pregnancy rate than any other available infertility treatment. However, IVF is the most expensive to perform on a per cycle basis. 
Uterine FactorsUterine factors describe any condition causing the interior of the uterus, (or endometrial cavity) to be abnormally sized or shaped, and/or non-receptive to an implanting embryo. Malformations of the uterus cause problems. They make it hard to maintain a pregnancy. An abnormal uterus may restrict the growth and development of a fetus which increases the possibility of miscarriage or premature labor. Some examples of congenital deformities of the uterus include the bicornuate, septate, and T-shaped variety. An HSG is an excellent tool for evaluating and diagnosing abnormalities of the uterine cavity. Many of these anomalies can be surgically corrected by your doctor at the Gyft Clinic. Other uterine factors may involve tumors called polyps and/or fibroids. They can impact the size and shape of your endometrial cavity and they may interfere with conception. Scar tissue as a result of infection or past surgery or trauma can also be problematic. These growths are usually benign and considered only a nuisance, but can hinder a pregnancy. This is because they take up the available implantation area for a developing embryo. Uterine tumors are usually detected with the help of an ultrasound and can be removed readily by your doctor. Scar tissue can also be removed, but can't be seen using an ultrasound. Scar tissue may need a laparoscopy to verify its presence. Irreparable Uterine Factors Irreparable uterine factors may prevent a woman from conceiving or carrying a pregnancy to term but don't necessarily prevent a woman from having her own children. The use of IVF with a gestational host allows embryos to be created from the eggs of the woman with the uterine problem and the sperm of her partner. The resulting embryos are then introduced into a woman with a healthy uterus who can likely carry the baby to term. We use the term "gestational host" to describe the woman carrying another couple's child. We do this instead of using "surrogate" as the term "surrogate" implies the woman is providing the service in exchange for money. Our gestational hosts are always a relative or close friend providing the service out of love, not money. Pelvic FactorsPelvic factors are less specific in terms of their location and generally refer to any condition in the pelvic area which may be affecting the reproductive organs. These may include the presence of scar tissue or pelvic adhesions from prior surgery or infection. They can include pelvic endometriosis, pelvic tumors or cysts. All of these can interfere with the normal function of the ovaries or fallopian tubes. We've discussed the impact of and ability to remove scar tissue and tumors from the uterus and they are basically dealt with in the same way in the pelvis. Endometriosis is a disease particular to the pelvis. It can cause a number of infertility problems related to the reproductive organs. Endometriosis is a condition where tissue perfectly resembling endometrium (or uterine lining), shows up in various locations in the pelvic cavity growing in and on the fallopian tubes and ovaries, sometimes debilitating them. The cause of endometriosis is not clearly known, but might involve the expulsion of endometrial tissue during menstruation upward through the fallopian tubes and into the pelvic cavity where it's able to implant and grow on the ovaries and elsewhere. It may also involve a hormonal change or other event that triggers undifferentiated tissue in the pelvis to transform into endometrial tissue. Regardless of the cause, if left unchecked could lead to complete infertility and cancer. Endometriosis usually requires a pelvic laparoscopy (see below) to verify its presence. During the same procedure, it can be removed by burning away the tissue with a laser or surgically cut out. Our Gyft Clinic doctors prefer to use lasers as they are believed to cause less pelvic scarring and depending on the severity of the growth, cutting out tissue can be a painstaking process. Cervical Factors Initiating a pregnancy requires the egg and sperm meet for fertilization to happen and usually occurs in the fallopian tube. For sperm and egg to meet, the sperm must swim from the vagina, through the cervix, past the uterus and into the tube. Conditions that block the ability of the sperm to reach the egg will prevent a pregnancy from occurring. Some cervical factors that can cause infertility include infection in the vagina or cervix, anti-sperm antibodies in the cervical mucus that can immobilize sperm, or poor quality cervical mucus that can prevent the passage of sperm into the uterus. Thus, it makes sense that we might want to examine the quality of the cervical mucus to determine if a cervical factor exists. The most common way we do this is by performing a Huhner or Post-Coital Test (PCT). The test is done by having the couple to be tested engage in intercourse as close as possible to, but before ovulation. The timing is important because the cervical mucus changes composition after ovulation and can actually prevent sperm from passing through. A small amount of mucus is extracted from the woman's cervix and examined for evidence of infection, proper clarity and "stretchiness", called Spinbarkeit. It's also tested for the presence of sperm. Sperm are evaluated regarding the number present, percent swimming, quality of movement, and physical appearance. A normal post-coital exam suggests a good vaginal and cervical environment and usually predicts a normal seminal fluid analysis. LaparoscopyThe laparoscopy is the most complete way of evaluating the pelvic anatomy and the reproductive organs for the presence of the variety of abnormalities mentioned above. It is a minor surgical procedure which lets the physician actually look inside the pelvic cavity. It allows your doctor to physically examine the uterus, ovaries, fallopian tubes and pelvic region for irregularities. Male InfertilityInfertility is not just a female problem. Male-related factors contribute to infertility problems in nearly half of the couples having trouble conceiving. There are a number of factors that can cause infertility in men that affect the quality of sperm. Problems with sperm production and/or blockage of the sperm delivery system, antibodies against sperm, injury to the testicle, or possibly the presence of a varicose vein around the testicle, called a varicocele, are all important to diagnose. All of these factors can affect sperm quantity and quality. Sperm quality is also thought to be adversely affected by stress, chemical exposure and strenuous exercise. Although temporary, illnesses, infections and medications can cause infertility in men. Problems associated with sexual dysfunction, ejaculatory dysfunction, hormone imbalance, testicular cancer and structural defects are rare and account for less than 3% of male infertility diagnoses. In our experience, low sperm counts, poor motility and/or abnormal sperm morphology make up most of the male factor infertility problems. There are effective treatments available to bypass the problems they cause. First, we'll determine if there is a male factor problem. One of the first tests your doctor will usually request is a Seminal Fluid Analysis (SFA). Please see "Reproductive Assays Lab" for specifics on collecting semen specimens, how the test is performed, and what is considered normal. The results of this test will go a long way in determining the fertility potential of the male patient. The results may signal the need for more detailed testing or treatment. Keep in mind the SFA is not an absolute test for fertility. The SFA doesn't actually test sperm function, i.e. test whether the sperm are capable of penetrating an egg, but is useful in determining obvious male factor infertility such as oligospermia, azoospermia, asthenospermia, severe agglutination, or teratospermia. Following are some of the actions typically taken as a result of a semen analysis outcome: Azoospermia: Refers to a complete absence of sperm in an ejaculate. If unexpected, a fructose test is performed to rule out congenital absence of the vas deferens and/or the seminal vesicles. Please see "Male Reproductive Process". A test for fructose is performed in such cases as fructose is a normal component of semen produced by the seminal vesicles. If there's no fructose in the ejaculate, then something is either missing or blocking that may be preventing the exit of sperm from the spermatic cord. If fructose is present in an azoospermic ejaculate, we can be reasonably sure that there are no anatomical defects of the sperm delivery system and the cause of the azoospermia lies elsewhere. Men with unknown azoospermia are usually referred to a urologist for more testing. Testing may include hormone testing and/or testicular biopsy. Use of anonymous donor sperm is a commonly recommended treatment for men with azoospermia. Please see "Sperm Donors" under Intrauterine Insemination for more information on the use of donor sperm. Oligospermia: Describes an ejaculate with an abnormally low number of sperm present. Normally there's no clear explanation as to why some patients have oligospermia. Factors may include hormone imbalance, past testicular disease or surgery. Other possibilities may include some of the behavioral/chemical factors mentioned at the beginning of this section. There are no clinically proven methods to increase male sperm count. As a result, oligospermic men have little hope of impregnating their partner the natural way. Your doctor may recommend a Sperm Penetration Assay (SPA). The SPA tests the function of the sperm. The results of an SPA may determine the treatment options available. Depending on the severity of the oligospermia, IUI and/or freezing multiple specimens for eventual thaw and "pooling" may be viable options for less severe cases. IVF with or without ICSI may be appropriate for more severe cases. Asthenospermia: Describes sperm showing poor movement. Speed and forward progression are affected. There's usually no clear explanation for asthenospermia. This is assuming the specimen was collected properly and was not exposed to any harmful environmental conditions. Asthenospermic men have little hope of conceiving naturally since such sperm are unlikely to reach their ultimate destination moving so slowly.  Tests for sperm function may be ordered by your doctor. When added to IUI-prepared specimens some chemicals have been shown to improve sperm movement. The chemicals are called pentoxyfylline and deoxyadenosine. Neither chemical has become routinely accepted, however, and sometimes the simple process of removing the sperm from the semen to a biological medium improves sperm speed and progression as is done in standard IUI preparation. In many cases, asthenospermia indicates the need for IVF/ICSI. Teratozoospermia: Describes specimens containing a high percentage of abnormally shaped sperm, also called poor morphology. It's common to have 50-60% of sperm with some type of head or tail defect. But men with teratozoospermia have significantly more. And sperm with abnormal morphology are more likely to be dysfunctional when it comes to fertilizing an egg. Your doctor may wish to test the functional nature of the sperm using the SPA test. The results may indicate the need for IUI or IVF/ICSI. Severe Agglutination: Describes sperm that, while thrashing about, are clumped together with little or no forward progression. Agglutination is sometimes the result of the presence of anti-sperm antibodies. They're common in men who have had vasectomy reversals. Your doctor may order an anti-sperm antibody screen in response to a high level of agglutination in the SFA. Please see "Reproductive Assays Laboratory" for information on how this test is performed. Anti-sperm antibodies are created when there is contact between sperm and immunocompetent lymphocytes in the blood. Sperm can enter the blood stream as a result of trauma, surgery, or infection. These lymphocytes attack the sperm by creating antibodies against it. The antibodies remain in the blood stream and are able to freely pass the blood-sperm barrier in the testis and attack the sperm waiting there. Once attached to the sperm, these antibodies appear to interfere with the sperm's ability to penetrate cervical mucus and/or the egg itself. Women may also develop antibodies to sperm. IVF/ICSI is indicated in cases of high levels of agglutination and/or anti-sperm antibodies. Varicoceles: A Varicocele is an enlargement of the veins of the testicle particularly in and around the spermatic cord. Varicoceles are usually located in the upper part of the scrotum and have historically been reported to occur in 24 to 41% of infertile men. This is a controversial statistic in many circles today. The mechanism by which a varicocele produces infertility is not well known or proven. It's generally believed to be related to an increase in the temperature of the sperm production centers as a result of the increased blood flow in the enlarged veins. But many specialists believe varicoceles play a negligible role in male infertility. In our experience at the GYFT Clinic, varicoceles are uncommon in explaining a man's infertility. Varicoceles are usually diagnosed by physical examination and ultrasound by a urologist. They can be surgically repaired by a high ligation of the spermatic vein. You've probably noticed a few similarities in the treatments available for the variety of sperm factors. IVF/ICSI is the only viable option with the highest success rate when dealing with severe male factor infertility. This is independent of the specific nature of the problem. Before the advent of ICSI in the past decade, men with the disorders mentioned had very little hope of becoming fathers of their own genetic children. TestingAt the Gyft Clinic, there are certain tests your doctor may recommend in order to get the most accurate diagnosis of your fertility potential. Some of these tests can be done through your own doctor, but are most conveniently done right here at our clinic in Tacoma. Thorough testing will help your Gyft Clinic doctor provide an accurate diagnosis which in turn will help in determining the best treatment options for you. Female Tests
Physical Exams
Male Tests
Contact the Gyft Clinic for affordable fertility and gynecology services. Schedule an appointment at 253-777-1964. |
Contact Us
Tel: 253 777 1964
Fax: 253 473 6715
Tel: 253 777 1964
Fax: 253 473 6715