If the first semen analysis is abnormal, a second analysis is required to confirm. The patient can then be referred to a reproductive urologist for further evaluation. Occasionally, certain male infertility patients will be asked to have the following tests:
Cystic fibrosis screening – Cystic fibrosis is a genetic disease that impairs the ability of the body to make secretions. Affected individuals produce thick mucus in the lungs and gastrointestinal tract making them susceptible to serious infections. Men who have no sperm in the semen due to occlusion or absence of the vas deferens have 1 in 4 risk of having the mutations and should be tested.
Chromosomal analysis – Some men with severely low sperm count (<3 million/ml) may have abnormal chromosomes and their sperm should not be used.
Y deletions mutation – In men with severely low sperm count (<3 million/ml), certain regions within the Y chromosome that are responsible for sperm production may be missing. Although pregnancy can result by IVF with ICSI, these mutations can be passed to the male offspring.
Sperm Chromosome Structural Assay – This test measures the prevalence of DNA fragmentation within the sperm head. Studies have shown that if a man has 30% of sperm with damaged DNA, he has a lower chance of having a biological child even with IVF and ICSI.