The Andrology Laboratory at the Toronto Centre for Advanced Reproductive Technology offers specialized tests to evaluate male infertility and provides referring physicians with accurate results using the latest technology available.
The laboratory tests available include semen analysis, viability test, peroxidase test for leukocytospermia quantification, immunobead testing to anti-sperm antibodies in serum, sperm or seminal plasma, bovine cervical mucus penetration test (BCMPT) to evaluate the mucus-penetrating ability of sperm, acrosome reaction test, and sperm DNA fragmentation assay.
Additional services include sperm preparation for artificial intrauterine insemination of partner’s fresh or frozen semen, or donor sperm.
Semen analysis is the most efficient and economical method of evaluating male infertility and is considered as initial step in infertility work-up. However, there is no single sperm assay that is a global indicator of male infertility. Semen analysis can be more useful when accompanied with a Hypo-osmotic swelling (HOS) test, BCMPT, and sperm morphology, all of which are described below.
Sperm morphology, along with sperm motility, provides the most important information on semen quality.
Semen samples with a low percentage of normal morphology are associated with poor fertilization potential of sperm. There are two major classifications of sperm morphology assessment, the WHO guideline and the Kruger strict criteria.
The HOS test yields information about functional integrity of sperm membrane. This assay can differentiate between immotile but viable spermatozoa from dead sperm. The HOS test may be used in selecting live sperm for ICSI, where there is little or no motile sperm.
The ejaculate contains cells other than spermatozoa; these include epithelial cells, prostate cells, spermatogenic cells and leukocytes.
The leukocytes, in concentration more than 1 M/mL, indicate inflammation possibly related to infection, which has been known as a cause for infertility. The Endtz test allows clear differentiation of WBCs from other cells in semen.
Male, mature spermatozoa formed after puberty can be recognized as foreign protein (antigen) by a man's immune system following vasectomy, ejaculatory duct obstruction, infection, varicocele, testicular trauma, testicular torsion, cryptorchidism and testicular cancer. Antisperm antibodies can be detected by different diagnostic tests such as Direct Immunobead Test and MAR test (Mixed Antiglobulin Reaction test). Antisperm antibodies are also detectible in seminal fluid, cervical mucus and serum samples.
Sperm viability staining measures the integrity of the cell membrane. Sperm that contain intact plasma membranes prevent the passage of certain stains, where non-viable sperm have defects within their membranes that allow staining.
A sperm viability test is important because it allows the differentiation of non-motile sperm with nonviable sperm. The presence of a large proportion of vital but immotile sperm may be indicative of structural defects in the sperm flagellum.
Sperm washing is performed to remove seminal plasma, increase sperm density and to enhance motility prior to intrauterine insemination. More advanced sperm preparation techniques include sperm swim- up and density gradients. These techniques can be used to eliminate non-motile sperm, white blood cells, seminal fluid, debris and highly efficient separation of motile sperm. The sperm preparation technique should be selected according to the individual semen samples.
Therapeutic donor insemination (TDI) is the use of anonymous donor sperm and is also available at TCART, for the treatment of infertile couples with severe male factor, such as azoospermia, severe oligozoospermia or genetic abnormalities.
The experienced personnel at TCART's Andrology lab are able to process and identify sperm from samples of per-coetaneous epididymal sperm aspiration (PESA), microepididymal sperm aspiration (MESA), and testicular sperm extraction (TESE). In many cases of azoospermia, sperm extracted from testicular tissue can be used successfully for ICSI procedure.
To refer a patient to TCART's Andrology laboratory, please call (416) 972 0110 or toll free at 1-800 520 0110 from 8:30 a.m. to 4:00 p.m. Monday through Friday.
Results of tests can be sent by mail, fax or e-mail to your office on request at the earliest convenience.
For more information or to schedule a laboratory appointment, please contact us at:
Toronto Centre for Advanced Reproductive Technology
210-150 Bloor Street West,
Toronto, Ontario, M5S 2X9
Telephone: (416) 972-0110 ext: 236
Fax: (416) 972-0036