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Male factor infertility is a complex problem and requires the expertise of specially-trained professionals who stay abreast of new developments in the field. Both the diagnosis and treatment of the male factor infertility has made significant progress in recent years. We have attempted to outline both the basic and advanced tests and procedures available at Coastal Fertility Medical Center. We hope you find the information helpful in this rapidly advancing field.
In order for a pregnancy to occur, sperm must travel from the male genital tract to the egg in the female and then penetrate the egg. This requires sufficient numbers of not only moving but functioning sperm that have the ability to undergo the biochemical process that enables them to fertilize an egg. An impairment in any aspect of this chain of events is called male factor infertility.
There is no single test to diagnose for male factor infertility. A work-up for male factor infertility may include: An analysis of the number of sperm (count); how many are moving (motility), and what sperm look like (morphology). Tests to identify sperm antibodies to determine the capacity of sperm to function (computer assisted semen analysis; CASA) and to assess the sperm’s ability to attach to (zona binding) and penetrate the egg (sperm penetration assay; SPA) may also be performed. Physical examination and semen culture can also be important components of the male work-up.
A complete semen analysis provides the basic starting point in any work-up for male factor infertility. It consists of a sperm count, sperm motility, sperm morphology, live-dead ratio, and cellular content at the microscopic level. In addition, macroscopic observations of the semen volume, color, pH, and viscosity are also reported. Recent advances in the analysis of these parameters include strict morphology (Kruger criteria) for patients with increased abnormal forms or low motility and CASA for poor motility or idiopathic infertility.
The turnaround time for this test is within a day.
The presence of antisperm antibodies can often be detected by the coagulation or clumping of sperm observed during a semen analysis. Also, unusually low sperm numbers or the presence of “twitching” sperm movement in the cervical mucus following a post-coital examination can often be an indicator of antisperm antibodies. Antibodies to sperm are frequently observed in patients that have undergone vasectomy reversal. By severely inhibiting sperm motility or sperm binding to the egg, sperm antibodies are a major causative factor in male infertility.
The turnaround time for this test is within a day.
The ability of human sperm to attach to and penetrate zona-free hamster eggs is highly correlated with their ability to fertilize human eggs. Men with normal semen analyses often display poor penetration due to incomplete capacitation of the sperm. If sufficient numbers are available, the sperm specimen can be split among 2-3 different preparations in an effort to identify the best treatment for IUI cycles or In Vitro Fertilization. The standard preparation is with isolate separation and then additional adjuvants such as test yolk buffer, follicular fluid, high salt or high protein may be included to improve the results. Furthermore, the average number of sperm penetrating the egg (penetration index) is a useful marker for deciding whether or not Intracytoplasmic Sperm Injection (ICSI) would be the most efficacious treatment to achieve fertilization.
The turnaround time for this test is within a day.
The male may undergo medical or surgical treatment appropriate to their medical condition. Additional treatment may include artificial insemination (AI) of the male’s partner with sperm that has been treated with a variety of methods. Some couples will undergo In Vitro Fertilization (IVF) using chemical enhancement for the sperm or Intracytoplasmic Sperm Injection (ICSI).
Isolate is the standard method of separating progressively motile sperm from non-motile sperm and cellular debris found in semen. The concentration of Isolate used, length of the Isolate column, and speed of centrifugation may all be adjusted to improve sperm separation and recovery in male factor cases that are not severe.
A number of chemicals have been identified which can be used to improve the quality of the specimen prior to insemination either vivo or in vitro. In general, these chemicals act by either improving the motility of many slow-moving sperm or improving the capacitation process. Repeated CASA and/or SPA following the use of adjuvants often reveals dramatic improvements in results. Examples of motility enhancers include chymotrypsin, pentoxifylline and deoxyadenosine, whereas TEST-yolk buffer, follicular fluid, high salt, and high protein have been shown to improve capacitation.
Male factor patients who show severely reduced sperm numbers, motility, or function often benefit from In Vitro Fertilization in combination with Intracytoplasmic Sperm Injection (ICSI). An ICSI procedure can also be successfully applied to couples in which sperm can only be obtained through a testicular biopsy specimen. The biopsy is performed by a Urologist, usually on the day before the oocyte retrieval.
Complete a semen analysis test from the privacy of your home
Coastal Fertility has partnered up with Posterity Health to offer you at-home semen analysis tests. This easy and convenient process allows men to learn about their sperm quality and fertility health and create treatment plans to overcome infertility factors.
Our fertility clinic focuses on helping you build your family regardless of your sexual orientation or the gender you choose to identify with. We are even taking further steps to make LGTB people feel more welcome at our fertility clinic. Each of our patient-facing staff goes through LGTB training to let family-building clinicians provide necessary support and make you feel highly welcome.
Coastal Fertility Medical Center offers one of the most advanced fertility treatments and is completely transparent regarding the costs of procedures and any other expenses that you may have to pay before commencing your treatment. This differentiates us from some fertility clinics that reduce prices before the signing of the contract but charge you extra later on. We make sure our patients are well aware of any possible extra pricing that may occur over the course of their treatment.
The infertility industry is currently segmented, with each service or treatment being handled by a different provider. Our all-inclusive model simplifies an otherwise complex and difficult process. We are here to revolutionize the infertility industry by offering a one-stop-service model to assist our patients through infertility challenges while reducing physical, emotional, and financial risks.
Our globally respected team of specialists are helping improve IVF technologies to enter into a generation of better outcomes for infertility. Although you’ll have a doctor guiding you, you are also going to benefit from the experience and insights of other doctors during case review collaboration meetings, which take place every week. So, you won’t just rely on the expertise of a specialist but benefit from the knowledge of many reputed fertility experts.
Our team specializes in difficult cases and help patients who may have been considered “hopeless” at other fertility clinics. Thanks to our personalized solutions, expertise, and internal collaboration, weare able to maximize pregnancy success rates that are well above the industry average, even in difficult infertility cases.
We know that every situation is different and that everyone requires different treatments. Unlike facilities that take “a one-size-fits-all” approach for all cases, our fertility specialists use more than 40 customized protocols to raise the chances of success. The customized approach even extends to our fertility laboratory. Our on-site lab director and his highly-experienced team nurture every embryo and egg to increase the odds of success of each cycle.
Coastal Fertility Medical Center offers one of the most advanced fertility treatments and is completely transparent regarding the costs of procedures and any other expenses that you may have to pay before commencing your treatment. This differentiates us from some fertility clinics that reduce prices before the signing of the contract but charge you extra later on. We make sure our patients are well aware of any possible extra pricing that may occur over the course of their treatment.
IVF and Frozen Embryo Transfer
Our IVF program helps international families complete their parenthood journey. Our IVF program is designed to make parenthood more accessible, especially for those requiring advanced fertility care.
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Following the Preimplantation Genetic Screening process, which helps ensure there are normal chromosome numbers and detects possible genetic disorders, the most healthy embryo(s) are selected to be implanted into your or your chosen surrogate’s womb. 2 weeks after the transfer of the embryo, your physician will conduct a final blood test to determine the level of hCG (human chorionic gonadotropin) in your body. Increased hCG levels usually indicate a positive pregnancy test.
For fertilization to take place, the collected egg and sperm are combined in a petri dish and cultured in an embryo incubator. This dish is closely watched to check whether any of the eggs have been fertilized. Once the egg is fertilized, it is referred to as an embryo or a blastocyst on the 5th day of development. Our in-house embryologist carefully nurtures every embryo to the right time, even if it means working outside the standard business operating hours. For instance: If an oocyte is not mature, our laboratory will wait for it to mature and then ICSI it at the right time.
The egg retrieval is a slightly invasive medical procedure that takes about 20 to 30 minutes. You will be given an anesthetic to make you sleep for the duration of the procedure. Using ultrasound technology, your doctor will harvest your eggs transvaginally with a small, hollow needle connected to an ultrasound probe. Once your eggs are collected, your partner’s semen or donor sperm you have pre-selected is used for fertilization. The sperm are washed and prepared, and the top-quality sperm extracted is used to fertilize the eggs.
Your doctor will create a customized medication schedule that contains information about the fertility medications and hormone injections you have to take. Medication and injections are taken to encourage your ovaries to mature a large number of eggs for fertilization. Since women don’t respond to fertility drugs and hormones the same way, personalized protocols are crucial to the IVF cycle success. At Coastal Fertility, we will monitor you closely, letting you understand the changes occurring in your body and keeping track of how your egg follicles are growing.
On-site consultations typicallyinclude a standard fertility evaluation, consisting of a physical examination, complementary follicular ultrasound, and testing to enable your doctor to know your present fertility status and draw up a treatment plan.
This consultation includes a detailed medical evaluation with a doctor. You and your physician will review your health records and have enough time to talk about your goals and get answers to your questions. We recommend that you jot down all your questions before the visit to allow you to make the best use of the time spent with your doctor.
Your Reproductive Endocrinologist will take all factors into consideration and create a comprehensive plan of care, otherwise known as the treatment plan. This plan will include treatment recommendations from the physician and enable your financial coordinator to make a precise quotation once you meet.
Our globally respected team of specialists are helping improve IVF technologies to enter into a generation of better outcomes for infertility. Although you’ll have a doctor guiding you, you are also going to benefit from the experience and insights of other doctors during case review collaboration meetings, which take place every week. So, you won’t just rely on the expertise of a specialist but benefit from the knowledge of many reputed fertility experts.
The infertility industry is currently segmented, with each service or treatment being handled by a different provider. Our all-inclusive model simplifies an otherwise complex and difficult process. We are here to revolutionize the infertility industry by offering a one-stop-service model to assist our patients through infertility challenges while reducing physical, emotional, and financial risks.
Our fertility clinic focuses on helping you build your family regardless of your sexual orientation or the gender you choose to identify with. We are even taking further steps to make LGTB people feel more welcome at our fertility clinic. Each of our patient-facing staff goes through LGTB training to let family-building clinicians provide necessary support and make you feel highly welcome.
We know that every situation is different and that everyone requires different treatments. Unlike facilities that take “a one-size-fits-all” approach for all cases, our fertility specialists use more than 40 customized protocols to raise the chances of success. The customized approach even extends to our fertility laboratory. Our on-site lab director and his highly-experienced team nurture every embryo and egg to increase the odds of success of each cycle.
Our team specializes in difficult cases and help patients who may have been considered “hopeless” at other fertility clinics. Thanks to our personalized solutions, expertise, and internal collaboration, weare able to maximize pregnancy success rates that are well above the industry average, even in difficult infertility cases.
Upon your arrival, you will check in with a Patient Care Coordinator. We will obtain your insurance information for benefits verification, a copy of your identification and take a picture for your electronic medical chart