Fertility Associates of Memphis

Male Infertility Services
Memphis Fertility laboratory, Inc
Kutteh Ke Fertility Associates of Memphis, PLLC

Introduction

Memphis Fertility Laboratory, Inc. and Fertility Associates of Memphis, PLLC offers a number of tests and procedures to diagnose and treat male infertility patients. These tests and procedures are collectively referred to as Andrology Services. Many of the tests help to determine to what extent, if any, male factor infertility is present. The procedures offered may assist couples achieve pregnancy when male factors may be present.

What Tests are Offered?

Semen Analysis
A semen analysis is the first step in the medical evaluation of a male's fertility. The patient is requested to produce a specimen at the in-office andrology laboratory. This analysis measures the number of sperm present in the ejaculate (sperm count); evaluates the shape and size (morphology); and measures the total volume and the percent of the sperm that are moving (motility). No significant white or red blood cells, sperm clumping and/or hyperviscosity should be present.

Fructose Test
If no sperm are found in the semen analysis, an additional test for fructose may be done. The absence of fructose may mean either the vas deferens are obstructed at or before the ejaculatory ducts, or the seminal vesicles are absent. A blockage may be the result of infection, including sexually transmitted disease, injury, or previous surgery that could have scarred the delicate tubules of the epididymis or obstructed the vas deferens. Congenital absence of the vas deferens is often found in patients with cystic fibrosis.

Dead/Live Sperm Stain
If the motility of the semen analysis is less than 35%, this test is performed to confirm the presence of living sperm. In some cases sperm may show no progressive motility but still be alive. The presence of a large portion of "live" but immobile sperm may be an indicator of a structural defect in the sperm tail.

Immunobead Test
The immunobead test is used to detect antisperm antibodies. These can be found in the serum, seminal fluid, or directly on the sperm. Antisperm antibodies may be formed when sperm are exposed to the immune system. Antisperm antibodies commonly form in about 70% of men following a vasectomy. Other causes that break down the barriers in the testes, such as infection or trauma, also lead to production of antisperm antibodies.

Endocrine Tests
Blood tests to measure circulating hormones can be performed to help reveal information about testicular function and causes of infertility. The pituitary hormones, FSH and LH, are both involved in the maintenance of sperm development and testosterone production. Prolactin and TSH, other pituitary hormones, also influences testosterone levels.

Retrograde Ejaculation Test
Retrograde ejaculation is a disorder that causes the semen to be released backward into the bladder during ejaculation. This condition may be congenital but also may be found in men with diabetes, multiple sclerosis, or who have had previous prostate surgery. It may be a side effect of certain medications, such as antidepressants and blood pressure medicine. Urine is collected and studied to determine if there is retrograde ejaculation present; if so, the sperm is evaluated.

What Procedures are Offered?

Husband Intrauterine Insemination (HIUI)
This is recommended for couples who are infertile due to impotence, low sperm count, decreased motility, retrograde ejaculation, or other sperm problems. This process involves the placement of the husband's washed and concentrated sperm into the woman's uterus. The success rate per cycle at Fertility Associates of Memphis is comparable to that of fertile couples conceiving during any given month. If the female also undergoes ovulation induction, HIUI can significantly increase her chances of conceiving. Click here for more information on HIUI.

Therapeutic Donor Insemination (TDI)
In cases where the male partner's semen quality is inadequate to produce pregnancy, a couple may use sperm from an anonymous donor. Before undergoing TDI, the female is required to have a pelvic exam and be tested for sexually transmitted diseases and other diseases. The doctor may also recommend a hysterosalpingogram or laparoscopy to check for obstruction of the fallopian tubes. At Fertility Associates of Memphis, our TDIs are performed with frozen sperm purchased by the patient from licensed sperm banks in the United States. At these sperm banks, the donors are required to undergo testing for HIV, hepatitis B and C, sexually transmitted diseases and genetic defects. Click here for more information on TDI.

Intracytoplasmic Sperm Injection (ICSI)
ICSI is a micromanipulation technique for severe male factor infertility. This laboratory technique involves the injection of a single sperm into the very center of the egg. The female must undergo in vitrofertilization (IVF) with ovarian stimulation and egg recovery in order to make use of this technique. ICSI may provide a chance to establish pregnancy for men who produce low amounts of weak sperm, men with blockage of seminal vesicles or vas deferens, and/or the absence of the vas deferens. The specialists at Fertility Associates of Memphis have been performing this laboratory technique since February 1995. Click here for more information on IVF.

Microepididymal Sperm Aspiration (MESA) and Testicular Sperm Aspiration (TESA)
The sperm used for ICSI can be obtained by ejaculation or directly aspirated from the epididymis or testes. MESA and TESA are procedures recommended for couples who suffer from severe male factor infertility. It is a surgical procedure that can only be performed by specially trained urologists. During MESA, sperm is extracted from the epididymis of the male partner and transported to the Andrology Laboratory for processing for IVF or cryopreservation for later use. TESA is a similar procedure in which sperm are isolated from testicular tissue. Our laboratory has assisted with urologists performing this procedure since 1997.

Cryopreservation
Fertility Associates of Memphis offer this technique to male patients who may be undergoing treatment such as chemotherapy, radiation treatment, varicocele repair, prostate surgery, or vasectomy that may render them infertile. A semen specimen is collected at our in-office andrology laboratory, processed, frozen, and stored. An annual storage fee is charged and the specimen will remain viable in storage for an indefinite period of time. In order to use the cryopreserved sperm, the female must go through a thawed intrauterine insemination or an assisted reproductive technology,

What is the Cost of Andrology Services?

The cost involved is dependent upon the tests that are required and the treatment that is performed. Insurance coverage varies widely. You should consult with your specific plan to find out what coverage is offered. We will be happy to provide an estimated cost analysis for each procedure at the time of your initial consultation.

How Do I Schedule Andrology Tests or Procedures?

Click here if you would like to schedule an appointment for testing or cryopreservation or if you have questions. You may receive information from one of our Andrologists, Nurse Practitioners or Physicians.