When couples simply can't get pregnant, the search begins for the cause. In about half of all cases of infertility, the man is the cause, regardless of his health or lifestyle. To clarify the situation, doctors have a spermiogram carried out. While a conventional spermiogram only gives information about the vitality of the sperm, an advanced spermiogram can give detailed information about your partner's fertility. Read here to find out how this advanced sperm test works and what information it can give you and your partner.

What doctors find out from a spermiogram

Men who want to find out about their fertility can have a spermiogram to find out how healthy their sperm are. To do this, they give their doctor a sample of their sperm, which is then examined in the laboratory. When the ejaculate is examined, the following aspects are examined in the conventional procedure:

• What is the structure of sperm? The technical term for this is morphology. Sperm are made up of a head, a body and a tail. If this natural structure deviates from the norm - for example, if the head is too small or there are two tails - this will have a negative effect on fertility.
• How motile are the sperm? The motility test determines whether the sperm are sufficiently mobile. Do they swim at high speed or do they stay in one place? Do they swim in circles? The more mobile they are, the better.
• How many sperm are there? The higher the total concentration of sperm in a man's ejaculate, the better his fertility - because more active sperm means a higher chance of fertilising a woman's egg.

If you want to know more about the state of your sperm, you will need to have an advanced analysis. This is usually necessary when infertility is diagnosed. Further tests are then carried out in the laboratory. The doctor will discuss these with you and your partner. There are many ways to test the semen sample for problems and defects.

The benefits of an advanced spermiogram

Advanced sperm analysis provides you and your partner with a detailed diagnosis. This is particularly important if the doctor identifies a serious fertility problem. In this case, the extended examination can be used to effectively investigate the causes and treat the problems accordingly in the next step.

The benefits at a glance:

• The process provides a comprehensive analysis and detailed information about the condition of the sperm.
• In addition to the DNA structure, the sperm can be examined for oxygen levels and possible defects.
• If you have had one or more miscarriages, an advanced spermiogram can help find out why.
• The advanced spermiogram allows targeted treatment.
• Artificial insemination (IVF) can benefit greatly from this procedure.

Advanced analysis: The individual tests at a glance

The process involves a series of different tests. Each test focuses on a different aspect. The aim is to find the cause of your infertility. This will enable the doctor to tailor the treatment to you.

The following tests can be done:

DNA fragmentation test

A DNA fragmentation test is a good option for couples who have had a miscarriage or who are suffering from infertility for which there is no known cause. It is also useful if you and your partner are considering in vitro fertilisation (IVF).

The DNA fragmentation test looks at the genetic material in the sperm. It uses a technique called flow cytometry to measure the stability of the sperm chromatin (a component of the cell nucleus) - this can tell you whether the material is broken, which can have a negative effect on fertility.

Men over the age of 40 who have undergone cancer treatment or are exposed to toxins at work should consider this test to find out more about their fertility.

Y-chromosome microdeletion test

A common cause of male infertility is a mutation in your own DNA. A Y chromosome microdeletion test can help you find out if your partner has one. This test looks at all four areas of the Y chromosome. This chromosome can be the main reason why there are fewer sperm in the ejaculate - or no sperm at all.

Detection of cell apoptosis

Apoptosis is the predictable death of a sperm cell. This happens whenever sperm cells have structural or functional defects. The process is also known as "programmed cell death".

Examination of the ejaculate provides information about the number of apoptotic sperm in the sample. High concentrations of sperm that are likely to die indicate limited fertility. This test is carried out using the protein Annexin-A5. This allows apoptotic spermatozoa to be labelled. In a second step, the previously labelled sperm are counted. This is done using flow cytometry.

If your partner has an unusually high number of defective sperm in his ejaculate, there is still hope. Fertility can be significantly improved by switching off the apoptotic sperm cells with the help of annexin acids. This process is also called "magnetically activated cell sorting".

Examination of the ploidy level

Wenn bei deinem Partner eine schwere Unfruchtbarkeit diagnostiziert wird, kann eine Untersuchung des Ploidiegrads Aufschluss über die vorliegende Störung der Spermien bieten. Oftmals sind unreife Zellen im Ejakulat der Patienten Ursache für die Probleme. Eine Durchflusszytometrie der Spermien ermöglicht es, diese Störungen besser einzuschätzen. Der Test gilt als zuverlässig. Er wird in jedem Fall durchgeführt, bevor eine mögliche Operation am Hoden in Erwägung gezogen wird.

Oxidative stress test

A disruption in the oxygen balance in the sperm can also lead to infertility. It is easy to find out if this is the cause with an advanced sperm test. The oxidative stress test measures the number of reactive oxygen species (ROS) in the semen sample. In principle, it is normal for sperm to produce a small amount of ROS - in fact, they are necessary for normal function. The level of ROS is controlled by the antioxidants in the seminal plasma - they are, in a sense, the counterparts in this system.

If the ratio of ROS to antioxidants is out of balance, the amount of ROS will increase. This in turn leads to oxidative stress, which significantly affects fertility.

The good news is that your partner can do something about this. A healthier lifestyle and a diet rich in antioxidants can reduce the increase in ROS.

Advanced spermiogram provides comprehensive diagnosis

If you have tried to conceive but have not been able to, or if you have had a miscarriage, your partner's sperm may be to blame. There are many reasons why an egg may not be fertilised or why a fertilised egg may be rejected. Sometimes it is due to breaks in the DNA, sometimes it is due to serious defects in the cell structures or an imbalance in the oxygen balance. An advanced spermiogram can tell you which of these problems is present. This is particularly important if you and your partner are considering artificial insemination.

Advanced sperm analysis and other tests will provide you with a comprehensive diagnosis, allowing you to receive the best possible treatment and make your dream of having a healthy baby a reality.