Sperm testing

Semen analysis

A semen analysis provides a relative measure of semen quality compared to the general population of proven fertile men.

The sample will be assessed for unusual amounts of debris (pieces of dead cells), suspected presence of bacteria, clumping of the sperm and for the presence of cells other than the sperm. The concentration (number), motility and the morphology (shape) of the sperm will be determined.

Trial wash

A trial wash is conducted at Sydney Andrology to provide you and your doctor with more detailed information on your sample and is used to assist making a decision on treatment options.

See a video of a trial wash being performed - View in Media Player (4 Mb)

If sperm are going to be used for infertility treatment they must be "washed" in order to separate the best sperm from the semen.

The standard washing procedure for the sperm used at Sydney IVF has been developed to work well for most men but it might not work well for some. A trial wash of your semen is required in order to make sure that the standard wash procedure can be used for you on the day of treatment. If the trial wash does not work well, the laboratory might be able to adjust it and wash the sperm differently or suggest other options for discussion with your doctor. Some washed samples may have very low sperm counts or very low motility and this information is valuable as it helps the laboratory to know what to expect on the day of treatment.

Your doctor will be provided with a summary of information from the laboratory about the semen sample and the quantity and quality of the sperm that it contains.

The laboratory will also indicate whether or not the sample quality meets the minimum established requirements for use in intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).

Please note that this will only be a guideline based on the semen sample you produce on that day; there might be other medical information that the laboratory is not aware of and the ultimate decision about treatment is between your doctor, you and your partner.

Sperm Chromatin Integrity Test (SCIT)

[was Sperm chromatin structure assay (SCSA)]

SCSA is a diagnostic tool that is used to calculate fertility potential and provide clinicians with a greater prediction of pregnancy outcomes. The DNA fragmentation index (DFI) quantifies the susceptibility of sperm DNA to fragment and provides a result that settles into one of the following ranges:

Fragmentation index	Result range
< 15% DFI	Excellent DNA Integrity
15 - 24% DFI	Good DNA Integrity
25 - 29% DFI	Fair DNA Integrity
≥ 30% DFI	Poor DNA Integrity

Traditionally, SCSA is run on a flow cytometer.  A review of the current methods highlighted potential variables. A known reference sample is used as a basis from which all diagnostic patient samples are analysed against. The gate set on the reference sample (undertaken daily by an Andrologist) is then used to distinguish between the fluorescent intensities for each sperm cell. There is potential variability between reference samples and the placement of the gate and this may affect the outcome of a diagnostic patient sample

At Sydney Andrology we have discovered that using a fluorescent image capture system is a much more sensitive and reliable method of detection and analysis. The major improvements are the precise identification of cells, analysis and results.  The image capture allows Sydney Andrology to introduce a level of cell discrimination not available via flow cytometry. Only sperm cells will be considered for analysis, as opposed to debris, bacteria and other cells.  The gate will be permanently fixed and will be controlled by samples (with a known DNA Fragmentation level) from an external quality assurance program. This will in turn, reduce variability of results and ensure results are comparable.

This new and improved testing method is now known as Sperm Chromatin Integrity Test (SCIT)

The total cell count on a flow cytometer is restricted to 10 000 which means that severe oligozoospermic patients or patients with reduced semen volumes (<1mL) are prevented from SCSA testing. This will allow these patients to be analysed. The number of sperm cells analysed with SCIT is user defined and therefore able to identify and analyse as little as 1 sperm. SCIT is set up to include approximately 20 000 sperm cells in each analysis and may be able to be increased if necessary.

SCIT is unique to Sydney Andrology and will provide clinicians with more precise and reliable results.

Please note that no semen test can fully predict fertility. Not all of the tests discussed above are appropriate for every couple. The tests performed will depend upon the findings during your evaluation and discussion with your doctor.