Looking after a man’s health is one of the key aspects that should not be overlooked when trying for a baby. At INVICTA Clinics, you’ll find doctors who specialise in male fertility. We also offer a wide range of tests. Find out how we can help you!
Our specialists don’t just look after women! Our range of services also includes comprehensive preventive health checks for men. We provide access to both basic and specialist diagnostics for fertility disorders, including, amongst others, detailed semen analysis, hormonal tests, imaging studies, infectious disease tests and genetic testing. Our multidisciplinary team of specialists (in the fields of reproductive medicine, andrology, endocrinology, genetics, immunology and psychology) uses advanced treatment methods and precise procedures for selecting sperm for fertilisation. We recognise the importance of the male factor in fertility disorders, which is why we are constantly expanding our knowledge in this area through our ongoing research and development projects.
Are you thinking about starting or expanding your family? It’s worth checking in advance whether you have any fertility issues, so that you can take appropriate action early on. For various reasons, either temporarily or permanently, semen may have abnormal parameters (e.g. sperm count, motility and normal structure, as well as ejaculate volume). The causes of these problems may be linked, for example, to illnesses suffered during childhood. One such condition is mumps. Complications can lead to testicular inflammation and, consequently, infertility. Abnormal semen parameters also occur in cancer patients following radiotherapy or chemotherapy.
Previous surgery on the bladder or the testicles themselves can also have a negative impact on semen quality. Prolonged exposure to high temperatures, as well as contact with toxic substances (heavy metals), is also detrimental. In addition, male fertility is affected by: wearing unsuitable underwear (too tight, made of synthetic materials), smoking, alcohol abuse, stress and the long-term use of certain medicines.
Most commonly, to assess male fertility, preventive tests are carried out, such as a laboratory semen analysis, which helps to identify the factors influencing the success of the fertilisation process.
Why is male fertility testing so important? Around 15–20 per cent of couples in Poland experience difficulties conceiving a child, whilst in almost half of these cases the cause lies with the so-called male factor. Male infertility, defined as the inability to impregnate one’s partner after a year of regular sexual intercourse (3–4 times a week) without using contraception, requires a holistic approach and care from doctors specialising in various disciplines.
Among the causes of infertility in patients undergoing in vitro fertilisation programmes, the following are identified:
male factor 35%
female infertility 36%
unexplained causes 15%
multiple factors (pair) 18%
As you can see, the male factor is just as important as the female one – which is why, to achieve complete success, it is essential to look after the health of both partners.
At INVICTA Clinics, we provide men with preventive health checks. We offer a private, comfortable environment, access to the latest diagnostic methods, and professional support in the areas of prevention and treatment.
For men who are not planning to start a family in the near future, appropriate fertility care is important. Once the basic diagnostic tests have been carried out, we recommend a consultation with an andrologist (a specialist in male fertility), who will provide key guidance on looking after your reproductive health.
Proper nutrition plays an extremely important role in supporting fertility. It is important to follow a balanced diet, rich in whole grains, fibre, polyunsaturated vegetable fats, selenium and zinc, as well as vitamins B, C, D and E.
In some cases, pharmacological treatment is necessary, particularly where there are hormonal disorders, sexual dysfunction or inflammation of the reproductive organs. Surgical procedures are carried out where clinically indicated. In cases of poor semen parameters, assisted reproductive techniques—including insemination or in vitro fertilisation—are often the only solution. The latter method enables the fertilisation of an egg using a single sperm cell. Advances in modern medicine have made it possible to select sperm of the highest possible quality prior to fertilisation. These methods offer many infertile couples, where the male partner has abnormal semen parameters, the chance of having the children they desire.
In the event of abnormal results, the doctor will guide further treatment or refer the patient for a sperm freezing procedure (to preserve fertility for the future). At this stage, we also recommend consulting a dietitian, who will draw up dietary recommendations aimed at improving fertility, and speaking to a psychologist, who will advise on how to cope with stress and the everyday pressures of work.
A general semen analysis (carried out at least twice, approximately three months apart), supplemented by testing for oxidative stress, provides basic information on male fertility.
This package enables the doctor to identify the most common causes of male infertility.
A general semen analysis involves examining a semen sample for key parameters (sperm count, quality and motility, ejaculate volume, liquefaction, etc.) and ruling out any potential abnormalities in this regard. The results obtained make it possible to assess the chances of conceiving naturally, diagnose the cause of any difficulties in conceiving, and, in the event of abnormalities, determine the most effective course of medical treatment.
General CASA (Computer-Assisted Sperm Analysis) semen analysis is a test that provides objective data on sperm concentration and motility. The microscopic image is processed by a computer and analysed in detail. Successive images record the position of the sperm head and plot the path it has travelled. This allows for a precise assessment of sperm motility parameters: average speed of the mean trajectory, average speed of progressive movement, average amplitude of lateral head deviations, straight-line progression and many others, which are used to classify sperm into subpopulations with different rates of movement and progression.
You should abstain from sexual activity for 2 to 7 days prior to the semen analysis. The sample is collected via masturbation. It can be provided at one of our clinics, in a special private room, or delivered to an INVICTA centre within 30 minutes of collection. The semen is submitted for analysis in a sterile container (such as that used for a general urine test).
INVICTA clinics carry out certified, computerised CASA semen analysis. This means that the test we perform holds an international certificate of reliability.
In 2010, the World Health Organisation (WHO) revised the reference values for the individual parameters of the semen analysis. The current values are set out in the table below.
Statistics based on data collected over recent years in the United States suggest that oxidative stress may be one of the main causes of male infertility. This means that in 30–40 per cent of men, elevated levels of so-called reactive oxygen species (ROS) are found in the semen.
Sperm cells produce a small amount of reactive oxygen species (ROS), which is essential for the proper functioning of biological processes. However, their levels should remain as low as possible. Once they have fulfilled their function, reactive oxygen species are removed by antioxidants present in the semen. An imbalance between the action of ROS and antioxidants causes oxidative stress, which in turn damages sperm and affects male fertility.
A simple test using a few drops of semen allows the level of oxidative stress in the sperm to be determined. If any abnormalities are detected, the doctor can plan appropriate treatment, including medication, supplementation and dietary changes, which will lead to improved results. Reducing oxidative stress can have a positive impact on male fertility and increase the chances of conceiving a child naturally.
High levels of oxidative stress disrupt the fertilisation process, negatively affect embryo development, and also reduce the chances of success in in vitro fertilisation programmes.
INVICTA Medical Laboratories were the first in Poland to introduce state-of-the-art tests enabling comprehensive and scientifically advanced semen analysis.
In addition to standard testing procedures, we also offer extended diagnostic services.
The MSOME (Motile Sperm Organelle Morphology Examination) extended semen analysis is an examination of sperm morphology under high magnification. Male diagnosis using the MSOME method allows for the assessment of intracellular structures within sperm, including the presence of vacuoles and their size. There is a link between the presence of vacuoles and damage to the sperm’s nuclear chromatin. Large vacuoles may suggest abnormalities in the semen (including chromosomal aberrations) or DNA damage.
The test is carried out, amongst other things, to assess a patient’s suitability for the IMSI-MSOME assisted reproduction procedure.
Testing for sperm DNA fragmentation allows for a detailed assessment of the quality of the man’s genetic material as a prognostic indicator of the likelihood of successful fertilisation, pregnancy progression and the birth of a healthy child. A standard semen analysis does not always provide all the necessary information to determine a patient’s fertility.
Embryos resulting from the fertilisation of an egg by sperm with an abnormal (high) degree of DNA fragmentation have a poor prognosis as early as the blastocyst stage (5-day-old embryo). When transferred to the uterus, they implant significantly less successfully, and pregnancies resulting from them are more likely to end in miscarriage, abnormalities, or an increased susceptibility of the offspring to cancer.
It is generally accepted that normal values are <15% of sperm with DNA damage. In cases of reduced fertility, the values range between 15 and 30 per cent. Where fertility problems are present, the values exceed 30 per cent.
Elevated levels of sperm DNA fragmentation are associated, amongst other things, with infections, fever, increased temperature in the testicular region, smoking, an unhealthy diet, substance abuse, exposure to environmental pollutants, as well as advanced age. Treatment – or, more precisely, minimising the level of fragmentation – depends on the underlying cause. If oxidative stress was the cause of chromatin damage, lifestyle changes and a balanced diet may help to reduce the extent of DNA damage. The use of antibiotic therapy in cases of infection should also result in a reduction in the level of fragmentation. The effectiveness of the measures taken should be verified by reassessing the quality of the genetic material 2–3 months after the initial analysis. If a couple is referred for in vitro fertilisation, sperm separation may be performed or material from a testicular biopsy may be used.
In 2007, the INVICTA Clinic was the first in Poland to carry out a sperm DNA fragmentation test.
The HOS (Hypo-osmotic Swelling Test) is an advanced semen analysis which allows for the assessment of sperm viability, as well as the analysis of the structural integrity of their cell membrane. In live sperm, in a hypo-osmotic environment, water passes through the semi-permeable cell membrane into the interior of the sperm, causing the tail to curl. This reaction is only possible in healthy semen, where the sperm have an intact cell membrane.
The test is carried out to identify live sperm.
The SOME+HOS extended semen analysis is carried out under very high magnification. It involves assessing the morphology of the sperm head and its internal structures, as well as evaluating the reaction of the tail in a hypoosmotic environment.
The SOME+HOS extended semen analysis is carried out, amongst other things, to assess a patient’s suitability for assisted reproduction procedures.
A test used to assess sperm quality and maturity is the sperm-hyaluronic acid (hyaluronan) binding test. This substance is present in significant quantities in the environment surrounding the egg. The ability of sperm to bind to hyaluronan is therefore important from the perspective of fertilisation. This ability emerges at an advanced stage of sperm development; consequently, the test can be used to assess whether sperm function is normal or abnormal and to determine their degree of maturity. Analyses also show a link between the ability to bind to hyaluronan and the morphology and quality of the sperm’s genetic material.
The test can be carried out provided there are motile sperm present in the semen, in sufficient numbers. It is recommended in cases of suspected idiopathic infertility and where further diagnostic investigation is required prior to any further medical intervention.
Sperm used in in vitro fertilisation techniques require appropriate preparation. Techniques for isolating sperm from semen involve: separating the sperm from the seminal plasma, removing substances that inhibit fertilisation, initiation of processes facilitating fertilisation of the egg, selection of sperm with normal morphology and motility, removal of bacteria and viruses, and selection of sperm carrying male and female chromosomes.
Techniques used in sperm isolation include:
The most commonly used method is sperm separation using the Percoll non-continuous density gradient centrifugation process (Density Gradient Centrifugation), which allows for the isolation of a homogeneous population of normal sperm, the separation of sperm from other morphological components of the semen, and carries a low risk of losing the few sperm present when their number in the ejaculate is low.
In 2008, the INVICTA Clinic was the first in Poland to carry out a sperm separation test.
A diagnostic testicular biopsy is a procedure involving the removal of a tissue sample for histopathological examination. The procedure is carried out via percutaneous fine-needle aspiration or by open surgical intervention. The biopsy is performed under general or local anaesthesia. The collected material is assessed for the presence or absence of spermatogenic cells and sperm. The isolated sperm are used in the fertilisation process via intracytoplasmic sperm injection (ICSI). A testicular biopsy is most commonly performed in cases of azoospermia (absence of sperm in the semen), to distinguish between azoospermia caused by obstruction and azoospermia without obstruction of the seminal ducts.
The most common genetic tests carried out in the diagnosis of male infertility are karyotype analysis, testing for CFTR gene mutations, assessment of Y chromosome microdeletions (AZF mutations) and sperm DNA fragmentation.
A karyotype analysis is recommended for men with azoospermia and severe oligozoospermia. Chromosomal abnormalities affect approximately 72–79 per cent of infertile men. In 66% of these cases, an abnormal karyotype result is associated with a diagnosis of Klinefelter’s syndrome. Karyotyping is recommended for all men with oligozoospermia who are beginning preparations for in vitro fertilisation.
Mutations in the CFTR gene cause cystic fibrosis. It has been found that the majority of men with cystic fibrosis are bilaterally absent of vas deferens (CBAVD). Some men who are heterozygous for the CFTR gene are also affected by CBAD. It should be noted that a couple carrying a mutation in the CFTR gene may benefit from pre-implantation genetic diagnosis.
The region of the long Y chromosome where genes essential for spermatogenesis are located is known as the AZF (azoospermic factor) region. It is believed that around 10% of men with azoospermia may have microdeletions in the AZF region. This region is divided into four subregions: AZFa, AZFb, AZFc and AZFd. The lowest chances of obtaining sperm in men with azoospermia are observed when the microdeletions involve the AZFa and AZFb subregions.
According to ACOG’s recommendations, all couples trying for a baby should be informed about the option of screening for the most common genetic disorders. Depending on their ethnic background, INVICTA Laboratory offers two versions of the test:
At INVICTA Clinics, you have access to doctors specialising in a range of fields, giving you quick and easy access to medical advice tailored to any kind of problem.
andrology
urology
endocrinology
psychology
genetics
immunology
As you can see, the male factor is just as important as the female one – which is why, to achieve complete success, it is essential to look after the health of both partners.
At INVICTA Clinics, we provide men with preventive health checks. We offer a private, comfortable environment, access to the latest diagnostic methods, and professional support in the areas of prevention and treatment.
The most common causes of male infertility are poor semen quality, low sperm count, problems with sperm motility, and other factors relating to sperm production and transport. The diagnosis and treatment of male infertility depend on individual circumstances.
Semen analysis is usually a minimally invasive procedure and does not cause any pain. It involves providing a semen sample for laboratory analysis. Our medical staff will ensure the patient’s comfort and explain the entire procedure step by step.
The time taken to diagnose male infertility may vary from case to case. Following the initial consultation and semen analysis, specialists will draw up a personalised treatment plan. The entire diagnosis and treatment process is carefully monitored.
The effectiveness of treatment for male infertility depends on the cause and individual circumstances. Our team of specialists uses advanced treatment methods that achieve high success rates. That is why it is worth trying treatment at the INVICTA Clinic.
Preparing for a semen analysis can help ensure accurate results. It is usually recommended that you avoid alcohol, stress, high temperatures and sexual intercourse for a few days before the test. Specialists will provide detailed guidance.
