additional tests available on sperm

while a standard sperm test (see Comprehensive Semen Analysis) looking at count, motility and morphology gives us a lot of information there are some problems that it does not show and so you may wish to consider additional tests...

DNA fragmentation

this is measured as a DNA fragmentation index, it gives the percentage of sperm cells that show DNA damage.

  • 15% or less is good to excellent
  • If above 25% show damage then IVF with ICSI would be recommended
  • 50% or more shows very poor DNA integrity

A 2014 study showed that 11% of men with normal sperm had elevated DNA fragmentation, and 5% of men with high normal sperm (measured as count 73 million/ml or above, progressive motility 55% or above, morphology 14% normal or above) also had elevated DNA fragmentation.

DNA fragmentation has been linked to increasing age and lower progressive sperm motility in both fertile and infertile men.  The test is recommended for men of 40 or above where conception or miscarriage are an issue.

oxidative stress

oxidative stress is known to be a factor in male infertility, it can affect both sperm quality and function, current thinking is that sperm abnormalities at a molecular level (which don't show on routine sperm counts) may contribute to 25% of cases of unexplained infertility. If oxidative stress levels are shown to be high then anti-oxidant supplements may be indicated.  New research has established a reliable test for oxidative stress in semen.

sperm aneuploidy

examines the sperm for chromosome defects, up to 13% of sperm with defects is considered normal, but higher percentages may affect conception or recurrent miscarriage risk.  The test is limited to specific chromosomes so may not pick up all defects.  Chromosome defects in sperm increase with age, lifestyle factors such as alcohol, smoking, caffeine and environmental pollutants, and some medicines.  Checking the sperm chromosomes can be done in addition to checking the blood karyotypes as some types of abnormalities relating to cell division only show in the sperm.

 

research

http://www.ncbi.nlm.nih.gov/pubmed/24690240 2014 study of men with normal sperm shows DNA fragmentation is linked to increasing age and lower sperm motility, 11% of men with normal sperm had elevated DNA fragmentation.

http://www.ncbi.nlm.nih.gov/pubmed/23722935 DNA fragmentation is linked to age with men of 40 or above having higher levels of DNA damage.

http://www.ncbi.nlm.nih.gov/pubmed/18558605 2008 review study suggesting that oxidative stress testing of semen should be incorporated routinely with semen analysis

http://www.ncbi.nlm.nih.gov/pubmed/25439800 December 2014 study establishing reliable testing for oxidative stress in semen