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What Do The Following Test Reports While Trying To Conceive Indicate?

Posted on Mon, 24 Apr 2017

Question: Not able to conveive last 5 years. Uploaded my latest (last week's) Semen Analysis, DFI, ROS reports. Kindly review and advise

Answered by Dr. Khushboo Priya (56 minutes later)

Brief Answer:
Hi, you have got asthenoteratospermia with high DFI.

Detailed Answer:
Hi, I think your sperms motility is on lower side. Morphology is also abnormal. DFI is quite high. ROS is also high. In my opinion, you should do a semen culture and sensitivity test. You can take some antibiotics like doxycycline 100mg twice a day for 10 days. Talk to your doctor regarding this. I will suggest you to undergo IVF with ICSI. Discuss with your doctor regarding this. Hope I have answered your question.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Khushboo Priya (28 hours later)

Thanks Doctor. I had recently developed skin infection on my scrotum sac (due to dryness) and my skin specialist had prescribed me Eumosome-M cream along with Tab Prugo (25 mg) - does the skin infection of the scrotum sac contribute towards semen quality paramerts like DFI or ROS?

Answered by Dr. Khushboo Priya (49 minutes later)

Brief Answer:
Skin infection doesn't affect DFI and ROS.

Detailed Answer:
Hi, I think the skin infection can't affect the semen parameters like DFI and ROS. DFI is mainly affected by smoking and alcohol intake. ROS is also affected by smoking and alcohol and the environmental pollution, but mainly it occurs due to seminal infections and presence of leukocytes. Skin infections has little to do with these parameters. Hope I have answered your question.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Khushboo Priya (2 days later)

Thanks. I recently did SpermAntiBody and Thyroid tests and both appear normal. Readings are as below:-

Test name: Sperm Antibody (ASAB) (Total), serum by EIA
Observed value: 17.71
Normal values: 0-60 U/mL

Test Name: T3 (Total), serum by CMIA
Observed value: 1.29
Biological Reference Interval: 0.58 - 1.59 ng/mL

Test Name: T4 (Total), serum by CMIA
Observed value: 8.29
Biological Reference Interval: 4.87 - 11.72 g/dL

Test Name: TSH(Ultrasensitive), serum by CMIA
Observed value: 0.70
Biological Reference Interval: 0.40 - 4.00 IU/mL
Ref: NACB guideline 2002

I am waiting on Semen culture report and my wife's FSH, LH, DHEA test reports, will let you know.

From all the discussion it now seems that ICSI is the only option left. But even that results are dependent on good sperm selection, especially if the DNA fragmentation is > 30%. Seems there are two options for this-
MACS (magnetic activated cell sorter) for sperm selection, or
TESA (testicular extraction sperm aspiration).
any thoughts on this please?

Regards.

Answered by Dr. Khushboo Priya (2 hours later)

Brief Answer:
MACS can be one option.

Detailed Answer:
Hi, I think MACS may be an option to select the best sperm. Many studies have been done which have shown increased pregnancy rates with MACS. It is particularly helpful when DNA fragmentation is high. TESA is not needed in your case because it is generally done in azoospermia cases or when semen can't be produced naturally. In my opinion, IMSI is also one of the option for you. In ICSI , magnification is around 700, while in IMSI magnification is much higher around 6000, which helps in better selection of sperms. Discuss with your doctor regarding all these options. Hope it helps. If you have any other query, I will be happy to help.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Khushboo Priya (48 hours later)

Thank you. Knowing about IMSI is useful. I will discuss with my doctor.

My semen culture report is fine - "No growth of pathogenic microorganisms"
My SpermAntibody (ASAB)(Total) serum by EIA = 17.71

My wifes report:
DHEA = 497.6 MCG/DL
FSH = 3.68 mIU/ml
LH = 2.27 mIU/ml
Free Testosterone (by Serum) = 4.0

Are all these reports normal? Thanks.

Answered by Dr. Khushboo Priya (19 minutes later)

Brief Answer:
Reports seems normal, DHEA on a higher side.

Detailed Answer:
Hi,
I think the reports are fine.

The DHEA is on a higher side. You can see the reference values in report. It varies from lab to lab. FSH and LH values are fine. Free testosterone is also normal if Value is in pg/ml. Just check it in the report. Your reports are fine.

Hope I have answered your question.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj