Once you've decided to do IVF, there are several tests that you need to have
to ensure optimal IVF success. Watch this video to learn about checking the
function of the ovaries. In today's episode of InfertilityTV, we
will cover sperm testing before IVF. Which tests are
important and which ones are not? We are going to cover the uterus in a
future episode. Make sure you subscribe now so you don't miss it.
Test number one - The most important sperm test
is the semen analysis. Does your partner have sperm? How many are there?
How many are good swimmers? how many look
normal under the microscope. If the semen analysis reveals the male
has low sperm counts, low sperm movement or a high percentage
of abnormal appearing sperm, then your IVF embryology team should use
the method called ICSI or intracytoplasmic sperm injection
to fertilize your eggs. Without it, you increase your chances for poor
fertilization or even failed fertilization!
However, even if the semen analysis is normal,
there is still a small chance of fertilization failure.
This is why at my IVF center outside Chicago
we always use ICSI to fertilize the eggs. Test number two - DNA fragmentation tests
First an explanation. Sperm are just very tiny transport vehicles to get the DNA
from a man into a woman's egg. There is a lot of DNA
and the sperm are very small so in order to get it all in there it has to be
really packed in tight. During this process
some of the DNA strands will break. This is called
DNA fragmentation. There are a number of sperm tests that measure the amount of
DNA fragmentation in sperm. Are these valuable tests to get before
doing IVF? I think the answer is still out.
There have been a lot of studies looking at DNA fragmentation
The American Society for Reproductive Medicine issued a practice guideline
which stated, "DNA damage is more common in infertile
men and may contribute to poor reproductive performance."
"However, current methods for assessing sperm DNA
integrity do not reliably predict treatment outcomes and cannot be
recommended routinely for clinical use." But let's say that I'm wrong and this is
a valuable test for IVF. What do you do with an abnormal result?
How do you improve your chances for IVF success?
Some doctors have recommended that men
take antioxidants like vitamin E or CoQ10. Does that work?
It doesn't seem so. A recent study found that antioxidants did not lower sperm
DNA fragmentation.
If you can't fix the fragmented sperm, can you separate the fragmented sperm
from less fragmented sperm? Maybe...
There are two methods of sperm selection that seem to lower the amount of
fragmented sperm. The first one selects sperm that are
able to bind to a chemical called hyaluronan which is normally
found around eggs. Sperm selected in this way have less DNA
fragmentation. Some studies have shown better embryo
development using this method but some haven't. There is a test called the
Hyaluronan Binding Assay or HBA that can be done before IVF. Men with a
low score might be more likely to benefit from
this type of sperm selection. Another technique is called microfluidic
sperm separation. With this method, sperm are selected based on their
ability to swim through tiny channels. The sperm that are
able to do this have lower amounts of sperm
fragmentation. It's a newer technique, so there isn't much research about how
effective it is for improving IVF but this one deserves to be watched in
the future. There are a handful of other sperm tests
that have been studied over the years but none have emerged as a valuable
addition for IVF pre-testing. Our InfertilityTV bottom line:
A semen analysis is essential if you're
going to be doing IVF. Other tests that assess for DNA
fragmentation are at this point questionable but since sperm have to be
selected somehow newer methods for sperm selection may be
used instead of the traditional methods. If you like this
video remember to like this video. If you have an idea for
a future episode of InfertilityTV leave it in the comments. subscribe now!
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