Trusted Diagnostic Tools for Undetermined Male Infertility

 Written by Ben Bunting: BA(Hons), PGCert.

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Having undetermined male infertility can be devastating. Thankfully, there are many trusted diagnostic tools that can help you determine whether you have an underlying condition or not. However, not all of these diagnostic methods are equally reliable, so it is important to know what to look for when choosing a test.

Testicular biopsy

Having a testicular biopsy is an important part of diagnosing male infertility. The primary aim of a testicular biopsy is to identify the different stages of spermatogenesis. This can lead to accurate diagnosis of infertility, thus improving fertility management.

A testicular biopsy is a surgical procedure in which a small piece of tissue is taken from each testicle. It is then examined under a microscope. The tissue sample can be used to evaluate the level of germ cell maturation and determine the etiology of NOA. It can also be used to retrieve sperm for use in assisted reproduction.

The testicular biopsy is usually performed in the same surgical procedure as the sperm collection for IVF. However, this does not guarantee that the procedure will be free from risk. The testicles are located in the scrotum, a fleshy pouch under the penis. A cold pack may be applied to the area for a few days after the procedure to reduce swelling.

The traditional method of handling testicular biopsy specimens is to fix the samples in formalin. This technique results in low microscopic resolution and has limited accuracy. Using glutaraldehyde or G/GMA, however, results in higher cytological resolution and better image quality.

The process of using a testicular biopsy is typically the same whether you are using a percutaneous or an open biopsy. In percutaneous biopsies, a thin needle is used to extract the sample, while in open biopsy, the skin is cut through. In both techniques, a small section of the testicle is removed and examined under a microscope.

The use of testicular biopsy as a diagnostic tool is often indicated when a patient's health history, hormonal assessment, and semen analysis are inconclusive. A variety of factors can contribute to male infertility, including anatomical or functional male defects, chronic illnesses, gonadotoxins, and sexually transmissible infections. A thorough evaluation of the male partner should include a comprehensive physical examination, a detailed history, and hormone testing. If the testicular biopsy reveals a reversible condition, treatment may be effective in improving male fertility and allowing for conception through IVF, IUI, or intercourse.

Sperm centrioles

Despite a significant progress in the understanding of the sperm centriole, the development of reliable diagnostic tools for undetermined male infertility using sperm centrioles has remained limited. In this study, we investigated the potential of posttranslational modifications of tubulin in sperm centrioles as a tool for the diagnosis of centriole-based infertility.

Traditionally, the diagnostic methods used for male infertility are based on morphology and motility assessment. However, a growing body of evidence indicates that the internal components of sperm play a role in male infertility. The proximal and distal centrioles are two of the three sperm components that contribute to the development of a male sperm.

The proximal centriole is a barrel-shaped organ that is located within the neck of the sperm. It is composed of nine microtubule triplets. In human sperm, the proximal centriole has a ratio of 0.54+-0.19, and in bovine sperm, the proximal ratio is 0.91+-0.12.

Currently, standard sperm analysis provides little functional information. To assess the reactivity of axoneme, anti-POC1B and tubulin antibodies were used. Flow cytometry tests were also performed. These techniques revealed that tubulin acetylation is weaker in the midpiece than in the proximal centriole. Moreover, tubulin immunoreactivity was more pronounced in the bovine proximal centriole than in the human axoneme.

In the cattle, the proximal and distal centrioles were labeled with anti-glutamylated tubulin antibody GT335 and anti-POC1B, respectively. POC1B is a known centriolar biomarker. Almost all the immunoreactivity was detected in the proximal centriole. In contrast, only a small portion of the immunoreactivity was detected in the distal centriole.

Similarly, we observed that the tubulin immunoreactivity was not present in the sperm axoneme. We conclude that the presence of tubulin modifications may affect the properties of sperm microtubules and therefore, they could be useful in the diagnosis of centriole-based infertility.

The assessment of sperm internal components is a critical part of a comprehensive evaluation of male infertility. Although currently not adopted as diagnostic testing, these methods have the potential to be implemented in animal breeding centres and human medicine.

Considering the importance of internal sperm components in the development of male infertility, it is crucial to understand the mechanisms involved. In addition, a more accurate diagnosis of infertility may provide an opportunity to correct problems in sperm production.

Semen analysis

Until now, standard sperm analysis has been limited by the lack of reliable quantitative diagnostic tests. However, new sperm components tests such as FRAC (Fractography Research in Andrology) have made it possible to identify male infertility in a broad range of patients. The test is not only sensitive, it is also time and cost efficient.

A FRAC assay can detect sperm defects in the centrioles. Specifically, it measures the intensity of staining in the sperm PC and DC. A FRAC ratio is calculated based on the sample fractions. For example, if the FRAC ratio is greater than 1.0 for a certain sample, it is considered to be of high quality. Similarly, if the FRAC ratio is less than 1.0, it is considered to be of low quality.

For this study, sperm samples were collected from 20 individuals, and their basic properties were analyzed. Sperm samples of 10 fertile men were evaluated, and the highest quality sperm was used as a reference group. The FRAC ratio was then calculated for the higher and lower quality sperm fractions.

The ratio was then compared to the mean percentage of the sperm with normal morphology scored by Dr. Kruger, who developed a set of strict criteria for assessing sperm morphology. This measurement has been shown to be a better indicator of fertility than the corresponding semen measurement.

In addition, a number of other tests were performed on the semen samples to assess their distinct features. For example, a sperm DNA fragmentation test was performed on neat semen samples. The results were compared to the standard value. The Spearman rank-correlation coefficient was always above 0.92.

In general, all six measurements have the same general characteristics. For example, a T-test for all six was performed and the results were above 0.05. The highest quality sperm sample had four outliers, which were more than one standard deviation away from the average.

However, a larger study is needed to determine whether or not the FRAC is capable of identifying male factor infertility. Future studies should also explore sperm deficiency and centriole-based infertility.

Sperm dark matter

Various diagnostic tools are available to detect male factor infertility, which is a condition that affects millions of couples worldwide. However, it is still unclear which sperm components cause infertility. As such, clinicians have to weigh the circumstances of each couple to determine the best treatment approach. The goal of this study is to assess the reliability of a new diagnostic tool, called the FRAC score, in identifying the cause of male factor infertility.

The FRAC is a diagnostic tool that has shown high reproducibility and is sensitive to sperm abnormalities. It is designed to provide information on the composition of sperm centriolars. This is accomplished by using the photon count per pixel, which ranges from 0 to 42. A thick line with brackets indicates the reference range for each FRAC variable.

The test is performed on neat semen samples. The sample is centrifuged for eight minutes at 250 x g. The pellet is then resuspended in Medium 199 media. After a few minutes, the supernatant is removed and the pellet is discarded. The remaining liquid is discarded appropriately.

This test has been used to identify male factor infertility in the same sample. A separate sperm content test is also available. These tests are complementary and do not replace each other. They can be used to identify male factor infertility when paired with a test that identifies the sperm components that are causing infertility.

Sperm analysis may be a useful diagnostic test, but there are many flaws. Standard sperm analysis does not measure the quality of sperm and provides limited functional and predictive information. A better method may identify undiagnosed male factors.

Sperm with defects can cause RNA abnormalities, DNA damage, reactive oxygen species, and centriole dysfunction. These problems are associated with reduced POC1B mRNA. They also decrease the chance of fertilization.

A lack of reliable diagnostic tools is a key problem in the diagnosis of unexplained male infertility. Fortunately, new research on sperm biology can provide a way to resolve this issue. The research is being conducted on sperm dark matter, which can lead to innovative treatments for male infertility.

Conclusion