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Comprehensive semen analysis

1. Functional sperm test (HBA test)

Biochemical ejaculate (sperm) examination: possibility to determine sperm maturity

If, a semen analysis (seminogram) shows that all the parameters are within normal, but pregnancy still does not occur, a biochemical semen examination is recommended. It is a functional test (HBA-test) to determine the maturity of the sperm and their ability to fertilise the egg naturally.

Immature sperm cannot fertilise the egg, while mature sperm can as it has special receptors on their heads to help them find the egg and attach to it. Sperm attached to the egg fuses with the egg membrane to get inside and fertilise the egg.

The test allows determining how many sperm are mature and fertile.

2. Sperm DNA fragmentation test

The DNA fragmentation test shows whether there is a chance to fertilise the egg naturally or whether the male factor is the cause of a spontaneously terminated pregnancy.

In such event, when the general sperm parameters, such as motility, concentration and morphology, are normal, the sperm can still be the cause of unsuccessful procedures.

The DNA fragmentation test is done to identify how many sperm have fragmented DNA. This manifests itself as breaks in the DNA strands in both or one DNA helix. If the break damages genes necessary for the embryo development and implantation, the embryo may die.

Possible causes of DNA fragmentation:

  • oxidative stress
  • infections
  • medicines
  • smoking
  • environmental pollution (heavy metals, polluted air)
  • age
  • diet
  • elevated testicular temperature, etc.

A DNA fragmentations test is recommended to patients with:

  • unexplained infertility
  • arrested embryo development
  • poor blastocyst formation
  • multiple failed cycles
  • early miscarriage
  • varicocele, etc.

In some cases, DNA fragmentation can be reduced by changing lifestyle, adding antioxidants that neutralise free radicals to the diet or treating conditions that may have caused the DNA fragmentation.

3. Comprehensive semen analysis

Before planning pregnancy, if previous attempts to have a baby have failed, it is important to remember that male infertility accounts for about 40%, but according to the latest data even up to 50% of infertility causes in couples. That is why we recommend doing a comprehensive semen analysis which includes:

  • Spermogram (semen analysis) - sperm motility, morphology, and IgG MAR test (agglutination reaction test);
  • Functional sperm test (HBA test) - to determine sperm maturity;
  • Sperm DNA fragmentation test - to identify amount of sperm without DNA damage​;
  • MiOXSYS test (a rapid semen test that accurately measures oxidative stress).

4. MiOXSYS test

MiOXSYS is a rapid in vitro diagnostic semen test that accurately measures oxidative stress. MiOXSYS test helps detect free radicals in the semen.

Free radicals are a product of metabolism and affect spermatogenesis. If excessive DNA fragmentation is present in the sperm, one of the causes may be reactive oxygen species (ROS). Excessive levels of reactive oxygen species in the sperm affect men’s ability to produce offspring.

Reactive oxygen species damage cell nuclei that contain genetic information or DNA. DNA strands react with reactive oxygen oxidising and fragmenting the DNA structure.

Mainly, the presence of free radicals is affected by various substances and processes to which we are exposed daily, such as tobacco, alcohol, household chemicals, radiation (laptop, TV, UV), pesticides, heavy metals, ozone, etc., as well as inflammations of male reproductive tract.

5. Fructose test

Fructose concentration test in ejaculate

Fructose provides energy for sperm movement and vitality and also contributes to sperm formation and development. Fructose is produced in the seminal vesicles thanks to androgen (male sex hormone) that get into the semen. Hormonal structure and quality impairment vesicular dysfunction lead to drop in fructose levels. The absence of fructose in the seminal fluid may be hereditary.

A fructose test is required to:

  • identify causes of azoospermia;
  • examine secretory function of the vesicles.

6. Alpha-glucosidase test

Alpha-glucosidase activity test in ejaculate

Alpha-glucosidase is an enzyme produced in the epididymis. Alpha-glucosidase activity levels depend on the secretory function of the epididymis. Reduced alpha-glucosidase activity may be a sign of a full or partial obstruction of the epididymis and ductus deferentes. It may be caused by inflammation or an infection. Alpha-glucosidase test may help identify secretory dysfunction of the epididymis and associated deterioration of semen quality. In men with reduced sperm motility (asthenozoospermia) alpha-glucosidase levels may point to epididymis insufficiency, which may be a sign of changes in gamete membranes or abnormal sperm morphology.

All test are done at the iVF Riga Clinic, 1st floor, Zaļā 1; to make an appointment, call: (+371) 67 111 117; (+371) 25 641 022;

! An andrologist consultation is recommended to rule out various health problems or conditions (prostate gland inflammation, other inflammations, varicocele, cryptorchidism, etc.) that may affect sperm quality and be a possible cause of infertility.

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