Glossary of Male Factor Infertility

Conception is a multifaceted process, and researchers are still uncovering its many intricacies. The field of artificial reproduction is largely unexplored and often depends on historical data. At the Embryo Family, we recognize that your partner’s sperm quality is an important factor in the conception journey, which can understandably add to your concerns. Much of your anxiety may arise from uncertainty about the findings of your partner’s sperm analysis and the requirements for an embryology lab to effectively fertilize eggs. To address the misunderstanding, we have highlighted the main concerns below to help reassure you that, in most situations, there’s no need for concern. Remember, you can always contact us regarding your partner’s sperm quality

Sperm Requirements for Egg Fertilization

The specific minimum sperm requirements for fertilizing an egg are not established, as the success rates can only be estimated on a statistical basis for each couple. Historically, there has been considerable variation in the semen criteria deemed necessary for effectively treating male subfertility.

The goal is to determine the essential semen parameters for partners of women undergoing IVF and third-party reproduction such as egg donation and surrogacy with an egg donor or her eggs. Research suggests that imposing strict minimal semen standards may have its limitations.

For IVF or insemination procedures, a minimum of 10 million sperm per milliliter is required, along with at least 30% motility and 15% progressive motility. However, pregnancies can still occur with lower sperm counts. Furthermore, at least 20% of the sperm should exhibit a normal morphology. However, it is still unclear whether these criteria will continue to be applicable.

The effectiveness of Intra-Cytoplasmic Sperm Injection (ICSI), a technique where a single sperm is directly injected into an egg, indicates that traditional quality standards may be outdated. ICSI has the potential to achieve fertilization and pregnancy even when using sperm that are immotile, have not undergone the acrosome reaction, lack tails, or exhibit abnormal or immature morphology.

Sperm Grading based on Motility:

Grade 1: Immotile: do not move at all.

Grade 2: Non-progressive motility: moving, but unable to make progress in any direction.

Grade 3: Non-linear motility: able to move forward, but does not travel in a straight line.

Grade 4: Fast and forward progression where sperm move in a straight direction.

Glossary of Terms | About Sperm

The three key aspects of your partner’s sperm are:

1. Sperm Count
2. Sperm Motility
3. Sperm Morphology

Below, we will delve a little deeper into these crucial factors that play a significant role in
the fertilization of oocytes.

Male Infertility | Male Factor Infertility (MFI)
Immotile sperm
Motility
Non-progressive motility
Semen Viscosity
ICSI
Sperm Morphology
Sperm Maturation
Sperm Agglutination
Sperm Antibodies
Sperm count

Sperm DNA Fragmentation (SDF)
Testicular Sperm Aspiration (TESA)
Non‐obstructive azoospermia (NOA)
Asthenospermia
Azoo
Oligo | Oligospermia
Pyospermia
pH – Presents of Hydrogen
Low pH
High pH (Alkaline Semen)

Volume

Varicocoele
Vas Deferens
Vasectomy
Clomid

Common Q & A | About Sperm

Q. Is IVF successful with abnormal sperm?

Pregnancies can still occur even with the presence of abnormal sperm. However, a significant amount of abnormally shaped sperm may indicate potential problems, like a low sperm count or reduced motility.

Q. Can IVF be done with low-quality sperm?

Absolutely, if you’re thinking about third-party reproduction or IVF and your sperm analysis indicates morphological problems, the laboratory can use any one of three sorting procedures to select the sperm with the greatest likelihood of success. However, using lower-quality sperm might lead to fewer viable embryos, which could lower the chances of implantation.

Q. What is sperm washing?

A lab technique is used to separate semen, which is the liquid part of ejaculate, from sperm. By choosing the most active and healthy sperm, sperm washing raises the chances of successful fertilization.

Q. What is Clomid?

Clomiphene is a drug that enhances the likelihood of conception by stimulating the body to produce an egg, a process known as ovulation.

Q. What is Varicoeles?

A varicocele refers to the swelling of veins located in the scrotum, the pouch of skin that contains the testicles. These veins are responsible for carrying blood that is low in oxygen away from the testicles. Varicoceles typically emerge during puberty and progress gradually. While they can lead to discomfort or pain, many individuals experience no symptoms or complications. A varicocele may hinder the growth of a testicle, reduce sperm production, or contribute to infertility issues.

If you have a small varicocele that is asymptomatic and does not affect your fertility, your healthcare provider may advise against treatment. However, if you have a more severe varicocele and choose not to seek treatment, it could result in lasting damage to your testicles.

Sperm selection | Embryology laboratory:

Q. PICSI - What is PICSI?

Physiological Intra-Cytoplasmic Sperm Injection (PICSI) is a technique used to select sperm to use in Intra-Cytoplasmic Sperm Injection (ICSI) treatment. It involves placing sperm with Hyaluronic Acid (HA), a natural compound found in the body. Hyaluronic acid acts as a lubricant and shock absorber in the joints. The enzyme hyaluronidase found in semen breaks down the gel (hyaluronic acid) surrounding the ovum, enabling sperm to penetrate the ovum effectively, leading to fertilization.

PICSI significantly improves IVF success rates by enhancing sperm selection and embryo quality. Studies have demonstrated higher pregnancy rates and lower miscarriage rates in IVF cycles where PICSI was utilized.

Q. IMSI

Intra-Cytoplasmic Morphologically Selected Sperm Injection (IMSI) is a methodology used in the Intra-Cytoplasmic Sperm Injection (ICSI) process to select sperm. This method involves using a microscope that magnifies sperm to an extraordinary degree (over 6,000 times their actual size) to identify the most suitable sperm for injection into an egg.

Q. MSS - Microfluidic sperm sorting

Microfluidic Sperm Sorting is a technique that selects healthy sperm with minimal DNA damage using a specialized chip. This method mimics the natural selection process of sperm as they navigate through micro barriers, similar to the female reproductive system’s fallopian tubes. The sperm that are sorted show improved shape, genetic quality, and more than double the viability and movement compared to unsorted sperm. This technique significantly lowers the number of sperm with damaged DNA and can increase the number of euploid embryos and the overall success rate of fertility treatments by up to 35%. An euploid embryo, or “normal” embryo, contains 46 chromosomes. These embryos have a higher chance of successful implantation, a lower risk of miscarriage, and a reduced likelihood of leading to a baby with intellectual or physical issues due to chromosomal abnormalities.

Additionally, Microfluidic Sperm Sorting is a gentle option compared to traditional sperm processing methods, as it does not require prior treatment of the sperm sample or the use of equipment that may increase oxidative stress on the sperm.

The information presented above highlights just a fraction of a much larger topic. Male infertility impacts approximately 93 million men globally, and encouragingly, nearly half of all cases can be effectively treated or reversed. It is essential to recognize that there is no singular, conclusive statistics regarding fertilization success rates for couples with low sperm counts, as each case is distinct.

At Embryon, we have achieved significant success by utilizing a wide range of available methods, and we continuously strive to stay ahead of trends and advancements in the field.

We are dedicated to supporting you throughout your journey to conception, whether that involves IVF, egg donation, or surrogacy.

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