Andrology Laboratory Services

Diagnosis of male fertility often starts with Semen Analysis (SA) which is based on sperm motility and macroscopic evaluation. often basic Semen Analysis (SA) may not accurately reflect the fertilisation ability of the sperm. This is when more comprehensive sperm function tests should be performed. 

Sincere Andrology Laboratory (SAL) is a one-stop centre offers a full spectrum of highly personalised care, support and fertility treatment options encompassing the following:

  • Investigations of male and female infertility with graduated treatment options such as Intrauterine Insemination (IUI), In-vitro Fertilisation (IVF) Intracytoplasmic Sperm Injection (ICSI), frozen-thawed embryo transfers, assisted hatching, blastocyst culture and in-vitro egg maturation. 
  • Andrology services to help azoospermic males including Microsurgical Epididymal Sperm Aspiration and Testicular Sperm Extraction.
  • Support all gynaecologists which include semen analysis, sperm preparation for IUI and sperm banking for husbands of patients.
  • Andrology services including sperm preparation for IUI, sperm freezing and storage for husbands who are not available during treatment or husbands with sperm retrieved from epididymis or testis or for men with cancer before cancer treatment. Our dedicated diagnostic laboratory provides services on semen analysis and related tests.

We are Singapore’s first and only Andrology Laboratory focusing on Oxidative Stress Assay (OSA), as it is not commonly done in other laboratories. Due to the less demand in the market, most laboratories do not perform such functional test.

Clinical Services

A Semen Analysis evaluates certain characteristics of a man’s semen and the sperm contained therein. The test is done as part of a couple’s infertility investigation or to verify the success of a vasectomy. It involves a combination of procedures to assess the semen quantitatively such as sperm concentration and qualitatively such as morphology, motility and vitality. Although this is a standard test, the diagnostic sensitivity is low and male factor infertility is frequently undetected. Approximately 15% of men with proven male factor infertility are found to have normal spermiograms. Accordingly, additional tests can be carried out to assess the functionality of the spermatozoa. Among them, the tests for the hyaluronan-binding ability (HBA), sperm DNA fragmentation (Halosperm), and sperm oxidative stress assay are simple and quick enough that the same semen sample tested can be used for the insemination of oocytes.

Spontaneous miscarriage occurs in 10–15% of clinical pregnancies in the normal fertile population but the rate is known to be higher in subfertile couples. Sperm DNA integrity is one of the important determinants of normal fertilisation and embryo development.

The Sperm Chromatin Dispersion (SCD) test, which is a simple, fast, and reliable procedure, is used to determine the frequency of sperm cells with fragmented DNA. The frequency of sperm DNA fragmentation is expressed as DNA Fragmentation Index (DFI). A sample with DFI <10% has high fertilisation potential while a DFI >30% denotes poor prognosis for IUI and IVF treatment and the man will require clinical treatment to improve his sperm quality.

The seminal plasma is well endowed with an array of antioxidants that act as free radical scavengers to protect the spermatozoa against oxidative stress. Sperm that have been exposed to oxidative stress have reduced motility, lower capacity to sperm-oocyte binding and fusion, and sperm DNA damage.

It is possible that excessive reactive oxygen species (ROS) generation by the human spermatozoa contributes to the aetiology of the male infertility. The result of such an oxidative stress is the induction of lipid per oxidation in the sperm plasma membrane, suppression of the sperm functions, and the precipitation of the DNA damage to both the nuclear and the mitochondrial genomes.

Sincere Andrology Laboratory can perform an assay that is reliable and sensitive to measure a possible excess of superoxide anions present in the ejaculate.

The Sperm Hyaluronan Binding Assay is a quantitative assay for the maturity of sperm in a fresh semen sample. This additional information will help the attending physician to identify patients with poor reproductive prognosis in Intrauterine Insemination (IUI) and In-vitro Fertilisation (IVF). It is not intended to be a single diagnostic indicator of potential fertility.

Sperm after washing and removal of seminal plasma are cultured for an extended period of time. The motility of spermatozoa is then checked after 24 hours. The specimen is considered normal if more than 70% of the sperms are alive and moving at 24 hours.

A Retrograde Semen Analysis is indicated for patients with a low volume and a diminished sperm count in the initial semen analysis. Retrograde ejaculation is the ejaculation of sperm into the bladder. Urine released following sexual activity will contain sperm in men who undergo retrograde ejaculation.

Many retrograde ejaculation patients will have had prior surgery or a medical condition that predisposes them to retrograde ejaculation, such as testicular cancer surgery (RPLND), transurethral surgery of the prostate, or childhood bladder surgery etc. Medical conditions such as diabetes, multiple sclerosis, or spinal cord injury may also predispose an individual to retrograde ejaculation.

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