Regional Fertility Program
Semen Analysis General InformationA semen analysis is the primary laboratory test for assessment of male fertility. A period of 2-3 days of ejaculatory abstinence (either through sexual intercourse or masturbation) is required before producing a sample for analysis. If ejaculation has occurred more recently the sperm concentration may be artificially low. In contrast, if the abstinence period is greater than 5 days the quality of the sample may be affected. The sample that you produce in the special private collection rooms at the DSL is immediately placed in an incubator.
The Diagnostic Semen Laboratory performs this analysis using the World Health Organization (WHO) guidelines. From the WHO standards a series of “normal” parameters have been determined as below.
The semen analysis includes assessment of the following:
Assessment for the presence of antisperm antibodies that may impair the movement and/or fertilizing ability of the sperm. Under normal circumstances sperm develops in the testes and are completely isolated from the circulatory system (via a blood/testes barrier). If there is a break in this barrier for any reason surface antigens on the sperm can cause the immune system to develop antibodies against the sperm. Antibodies are common following vasectomy or vasectomy reversal and may impair fertility.
Intrauterine insemination (IUI) involves the placement of “washed” sperm (partner or donor sperm) into the uterine cavity prior to ovulation. The chance for conception is increased by placing a large number of motile sperm high in the uterus. The sample for IUI is collected by masturbation at the DSL the morning of the insemination procedure. Approximately 2 hours are needed to perform the "sperm wash" procedure. Sperm washing is also required for Clomiphene Citrate / IUI and Superovulation / IUI cycles.Sperm Evaluation for IUI
Not all semen samples are suitable for IUI treatments. Samples with reduced concentration, decreased motility or the presence of antisperm antibodies may not be retrieved in the “sperm wash”. An IUI evaluation may be advised prior to starting treatment to determine the suitability of a man’s sample for IUI.
Preparation of Sperm Samples from PESA, MESA, TESE, Vibrostimulation, and Electroejaculation/cryopreservation
This option is available for patients wishing to store sperm for future use include those men having radiation, chemotherapy or other treatments that may render them infertile. Sperm samples obtained through masturbation, PESA, MESA, TESE, as well as vibrostimulation and electroejaculation can be processed and cryopreserved (frozen) and stored indefinitely for future use. Service members serving in war zones may wish to store sperm samples prior to their deployment for future use. Cryopreservation and storage of sperm is not paid for by the provincial health care plans and patients using this service will incur initial and annual charges.
The Procedure of Cryopreservation
Samples are assessed for motility and concentration prior to freezing. The sample is mixed with a biocompatible cryoprotectant and frozen in small straws. The straws are frozen in liquid nitrogen. A portion of the frozen sample may be thawed and examined to assess the post-freeze viability and mobility of the sample.
Due to the nature of the sperm freezing it is usual for motility and concentration to be less after freezing and thawing than in the original fresh sample. Therefore there can be no guarantee that the frozen sperm will be suitable for future use. Once frozen the sample may be kept indefinitely. The majority of degradation of the sperm quality occurs at the time of the freeze, not during storage.
Donor Sperm Bank
Effective January 2011, the Diagnostic Semen Laboratory is no longer responsible for ordering donor vials for patients of the Regional Fertility Program. Patients are required to directly contact the three banks sourced by the Regional Fertility Program to order and purchase their own donor samples. These banks are Outreach Health Services (Xytex Corporation), Repromed Ltd. (Toronto, Canada) and Can-Am Cryoservices (Virginia, USA). Payment will be given directly to the chosen donor bank prior to shipment. All donor vials will be delivered to the Diagnostic Semen Laboratory. The use of donor sperm for fertility treatments is regulated by Health Canada. All Canadian sperm banks and clinics using donor sperm are inspected by Health Canada to ensure compliance with federal regulations. The staff at the donor banks will assist patients in the donor selection process.
Deletions of small amounts of genetic information from the long arm of the Y chromosome may be found in 10-15 percent of men with no or very few sperm. These microdeletions are too small to be detected by normal karyotyping and must be tested for in special labs. The deletion of genes from the Y chromosome may significantly affect the production of sperm. Microdeletion test results are used to predict the likelihood of success of finding sperm from testicular biopsies. This assay is performed on a blood sample from the male partner.
It is thought that sperm with a high proportion of fragmented DNA have a reduced capability to fertilize an egg. Patients that have had failed fertilization or had excessive fragmentation of their embryos in a previous in vitro fertilization cycle may consider utilizing sperm DNA testing to detect this potential problem. The semen samples are flash frozen in liquid nitrogen and sent to a special lab for analysis. A percentage score is generated from the assay with lower percentage scores indicating more favorable fertilization potential.