Fertility assessment

Semen analysis

Semen analysis is an essential means of diagnosing the cause of male infertility. It’s simple, non-invasive and is one of the first investigations we carry out. What’s more, the test results are available immediately so you can discuss your fertility options with one of our team soon after.

A semen analysis, or sperm test, is an essential part of your fertility assessment; whether you’re visiting us as a single man, a couple or if you wish to become a sperm donor.

Semen analysis tests your ejaculate for the volume of semen, consistency, sperm concentration and sperm quantity, sperm motility, the ratio of healthy vs abnormal sperm, vitality levels and several more factors that have some bearing in conception – especially for certain fertility treatments.

It’s a straightforward and simple process and not one you should feel in any way embarrassed by. Because we need to test sperm quality within an hour of ejaculation, we provide you with a quiet, private room in which to provide your sample. If you are unable to produce a sample, we can carry out percutaneous epididymal sperm aspiration (PESA), where we take your sperm sample directly from the epididymis.

Our semen analysis report will provide information on the number of sperm present, its motility, morphology (i.e. their appearance), volume and appearance of the sample. The presence of inflammatory cells that could indicate an infection as well as the presence of antibodies that could impair fertility will be assessed. With these results, our experts can advise you on how best you can optimise your fertility. This could be as simple as making a few lifestyle or diet changes or we will need to advise on which male fertility treatment is necessary to help you achieve a successful pregnancy.

If the results show that there are any problems likely to lead to reduced fertility, we’ll talk you through our andrology services and give you all the support you need.

Our andrology services include:

• semen analysis
• post vasectomy/vasectomy reversal semen analysis
• retrograde ejaculation diagnosis
• anti-sperm antibody diagnosis
• sperm banking for social or medical reasons

If further screening is required, genetic integrity testing can be arranged:

• DNA fragmentation testing
• Y chromosome microdeletion screening
• Cystic fibrosis screening

Your investigations and treatment will be managed with sensitivity and the utmost confidentiality whilst providing expert medical care to enable you to achieve your dream of fatherhood.

How do I make an appointment?

Finding out more information or making an appointment for semen assessment is quick, easy and strictly confidential, and you do not need a GP or hospital referral. Simply call us on 01992 78 50 60 or email enquiries@hertsandessexfertility.com.

We also welcome patient referrals from GPs and other healthcare professionals.

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Q: We are struggling to conceive after having a natural conception. Will the One-Stop Fertility Assessment give us answers?

A: Yes, in most cases our fertility tests identify the likeliest causes of infertility. Many couples struggle with what we call Secondary Infertility, which is when couples either cannot conceive or can conceive but cannot carry a baby to term after a perfectly normal first pregnancy and birth. In fact, Secondary Infertility is more common than Primary Infertility.

Reasons for Secondary Infertility tend to be the same as for Primary Infertility. It is likely that since you were last pregnant, you or your partner may have had an infection, your egg quality may have declined or your partner’s sperm quality or quantity may not be what it once was. Other common explanations for Secondary Infertility include endometriosis, pelvic adhesions, uterine fibroids, polyps or ovulation problems.

Q: What is AMH?

A: AMH is the abbreviation for anti-Mullerian hormone. Since AMH is produced only in small ovarian follicles, the level of this hormone is used to measure the size of the pool of potential growing follicles in women. Put simply, AMH blood levels reflect the size of your remaining egg supply or your ovarian reserve.

As a woman gets older, the number of remaining microscopic follicles decreases, as does the AMH and the number of ovarian antral follicles visible on ultrasound.

Women with many small follicles, such as those with polycystic ovaries, have high AMH hormone values and women that have few remaining follicles and those who are close to menopause have low AMH levels. AMH levels do not vary with the menstrual cycle, so we can measure them at any time of the month.

Q: What is a transvaginal 3D scan?

A: A standard 2D scanning image shows only a single slice taken through the anatomy at a time, whereas a 3D ultrasound takes a number of 2D images at any one time. These images are used to create spectacular three-dimensional, lifelike pictures of the womb. We use a vaginal probe to take transvaginal 3D scans and it is a standard part of routine gynaecological procedures at our Centre.

Q: What is a Saline Infusion Sonogram (SIS)?

A: A Saline Infusion Sonogram (also referred to as Saline Sonography) is a special ultrasound test to check whether the uterine cavity (the inside of the uterus) is normal.

Q: Why do I need a Saline Infusion Sonogram?

A: Benign or non-malignant uterine growths, such as endometrial polyps or uterine fibroids, can develop in the uterine cavity and create an environment that is hostile to the implantation of an embryo. The sonogram can also identify scar tissue that needs removing. A routine ultrasound scan will identify larger growths, but small ones can only be seen using Saline Infusion Sonography.

Q: How is Saline Infusion Sonography performed?

A: The procedure is simple and usually takes just 10 to 15 minutes. A special catheter (about the size of a single strand of spaghetti) is inserted through your cervical canal. An ultrasound scan is performed as a sterile salt-water solution (saline) is injected through the catheter into the uterine cavity. The fluid distends the cavity allowing a good view of the entire inside of the womb.

Q: What is HyCoSy?

A: Hystero-Contrast-Salpingosonography (HyCoSy) is a non-invasive ultrasound procedure used to check if the fallopian tubes are open or blocked.

A thin catheter (tube) is passed through the cervix into the womb and a tiny balloon is inflated to hold the catheter in place. A transvaginal ultrasound scan is performed and a contrast fluid is injected through the catheter into the uterus. The fluid shows up as bright white and its path can be followed in the uterus and through the fallopian tubes on each side. If the fallopian tubes are patent (not blocked) the fluid will spill easily into the pelvis. After determining the patency of your tubes the catheter is removed.

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