Surprising? Even though all the sperm analysis parameters look fine, you will have trouble having a child. That’s when urinalysis is done.
There are 5 “biomarkers” present in the urine that are evaluated to check for “normozoospermic” infertility. Normozoospermic Infertility is a condition when the sperms cells look healthy and all the parameters are normal but the sperm cells are themselves infertile.
Hormone Levels Testing
Human body is a big interconnected network of tissues, organs, hormones etc. Hormone testing is necessary not just to check the testosterone levels but also other hormones including:
- FSH – Follicle Stimulating Hormone
- Luteinizing Hormone – LH
The pituitary gland releases FSH and LH that will trigger the production of testosterone by the testicles. Testosterone hormone is required for production of sperms.
High amounts of FSH indicate that the testicles are not functioning properly. Low levels of FHS indicate that you are not producing sperm. The Luteinizing Hormone binds to the receptors in the Leydig cells to release testosterone.
Healthy men have testosterone levels anywhere in the range of 300 to 1000 ng/dL (nanograms per decilitre). As you may be aware, testosterone levels start to decrease at the rate of 1% per year, after a man reaches 40 years of age.
When the hormone levels are also fine, your doctor will then go for imaging tests.
Imaging tests to check anatomical issues and obstructions
- Scrotal Ultrasound is done to look for any infections, tumors, cysts or filling up of fluids, testicular torsion or varicocele.
- Transrectal Ultrasound is done using a probe that is inserted into the anus to check for obstructions in vas deferens, prostate condition.
Looking for Anti-sperm antibodies
Usually semen or sperms don’t mix with any other fluids in the body. For any reason if the immune system or the corresponding cells reach the sperms, they may treat sperms as foreign bodies and start attacking and killing them by producing anti-sperm antibodies.
If the anti-sperm antibodies are present, your doctor may be put on medicine that reduces immune response of the body.
A small sample of testicle tissue is taken (either through a needle or by making an incision on the scrotum) and checked for presence of cancer causing cells.
When all the other rest results are good, you will be advised to take a genetic test which can reveal a great deal of information about the DNA and chromosomal abnormalities. If this test is the first one to be performed, it can rule out all other conditions and shorten the diagnosis process.
When every test including genetic testing is Ok and still you are not able to impregnate your partner, what does that mean?
For any disease for which the cause/reason is not known, it is termed ‘idiopathic’ and in case of infertility, it is called ‘idiopathic infertility’ meaning that the reason for infertility is not known or couldn’t be identified.
When you present yourself (and your partner) to a sexologist, after initial few questions, the next thing that happens is testing. You should not be scared to get the tests done. If you are worried about the cost of infertility tests, you should speak to your insurance company or the person in the clinic to find out if the testing cost and treatment is bored by the insurance company.
Cost of each test varies from lab to lab, clinic to clinic and with the specialties the hospital or clinic provides.