When a married couple has difficulty in conceiving naturally for a year, this may be due to fertility issues in either the female or male partner or both.

In many cases, studies have shown that men contribute 40-50 percent to the causes due to abnormal sperm production or function. Yet, male infertility is often talked about in hushed tones, but like female infertility, solutions are at hand and understanding one, such as andrology, is the first step men can take. For the uninitiated, andrology is the study of male health, especially focused on the reproductive system and even urological concerns for men.
The male is said to be infertile if his sperm quality is below the accepted 2010 World Health Organization (WHO) norms; the sperm density should be more than 20 Million/ml, motility (how well the sperm swims) should be more than 50%, and normal forms should be more than 14%, amongst a few other parameters.

Treatment of male infertility starts with a Semen Analysis (SA) to check for sperm volume, motility and morphology (shape or form). However, the diagnostic sensitivity is low and the underlying causes are not detected in SA.

For more accurate diagnosis, Sincere Andrology Laboratory offers advanced sperm functional tests that will provide more specific information about sperm formation to help physicians pinpoint the male factor infertility and develop an optimal treatment plan for their male patients.

Some of these advanced sperm functional tests are not available in general laboratories in Singapore as they require skilled laboratory technologists to perform the tests. Some of these advanced tests include the Sperm DNA Fragmentation and Sperm Oxidative Stress Assay to determine for abnormal levels of free radicals that may damage sperm or if sperm had already been damaged. Damaged sperms may cause defects in embryo development, giving rise to the risk of pregnancy loss or problems with foetal development.
SA (Semen Analysis)
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.
DNA Fragmentation Assay
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 fertilization 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 fertilization 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.
Sperm Oxidative Stress Assay
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 reduce 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.
Hyaluronan Binding Assay (HBA)
The Sperm Hyaluronan Binding Assay is a qualitative 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 Intra-Uterine Insemination (IUI) and In- vitro Fertilization (IVF). It is not intended to be a single diagnostic indicator of potential fertility.
Survival Test
Sperm after washing and removal of seminal plasma are cultured for 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.
Retrograde Semen Analysis
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, MS, or spinal cord injury may also predispose an individual to retrograde ejaculation.
Other Tests
● Trial Wash
● Freezability
For individuals seeking semen analyses, you may make an appointment to consult with our Specialists at the Sincere Andrology Laboratory at Hotline: +65 6507 0766 email: andrologylab@shg.com.sg or simply fill up the form below.
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