Andrology Laboratory - Liv Hospital

Andrology Laboratory

An andrology laboratory is a type of laboratory that deals with male reproductive health. These laboratories are units that perform various tests and analyzes related to the male reproductive system. Sperm analysis, evaluation of hormone levels, genetic tests and other andrological examinations are among the common tests and analyzes performed in these laboratories. Andrology laboratories play an important role in diagnosing and treating various reproductive health disorders.

Liv Hospital Andrology Laboratory

Liv Hospital's Andrology Laboratory is equipped with modern technology and an expert team on male reproductive health. The laboratory provides personalized treatment plans to patients by performing sperm analysis, evaluation of hormone levels, genetic tests and other andrological examinations with high precision and reliability. Liv Hospital Andrology Laboratory provides a leading healthcare service in offering special solutions to male patients by prioritizing reproductive health.

Taking a Sperm Sample

For routine andrology laboratory procedures, a semen (ejaculate) sample must first be taken from the man via masturbation. In cases where it is not possible for the patient to ejaculate in this way;

Through sexual intercourse using special condoms that do not contain spermicidal chemicals,
With the use of devices that provide ejaculation by stimulating the male sexual organ with appropriate doses of electrical signals, called electroejaculation,
In cases called dry ejaculation (retrograde ejaculation), semen is ejaculated into the bladder during ejaculation. In this case, by taking sperm cells from the urine sample taken immediately after ejaculation,
In case of any blockage in the sperm ducts that prevents the semen sample from coming out, by taking a sample with a syringe from the epididymis region, where mature sperm are accumulated in the testicles,
In cases where there is no sperm in the semen sample, defined as azoospermia, or there is a blockage in the sperm ducts or decreased sperm cell production, sperm can be obtained by taking a piece or sample from the testicular tissue using TESE or TESA methods.
The ideal timing for this procedure is simultaneous with the time when the patient's partner's eggs will be collected. Semen analysis is the first test used in infertile couples to evaluate male reproductive potential and the following parameters of the ejaculate are evaluated:
Evaluation of semen volume and pH and fluidity
Sperm number, motility and morphology (shape features)

The sperm sample to be used for semen analysis is taken after 2-8 days of sexual abstinence. This period is important in terms of obtaining the appropriate sperm count/viability ratio. Less than two days of sexual abstinence causes a low number of sperm cells, and more than 8 days of sexual abstinence causes decreased motility.

Semen analysis results are interpreted according to the standards set by WHO (World Health Organization):

Normal Values:

Volume – 1.5 mL
pH – <8.0
Sperm Count – 15 million sperm/mL
Total sperm count – 39 million sperm/ejaculate
Morphology – 4% normal shaped sperm, according to Kruger Strict criteria
Vitality – 58% live sperm
Forward mobility – 32%
Total mobility – 40%
Leukocyte – <1 million/mL
Immature germ cell – <1 million/mL

It is defined as the minimum threshold values required to achieve normal pregnancy. In cases where semen analysis is not sufficient, additional tests may be performed.

Special Semen Analysis Tests:

Semen biochemistry: Tests applied to measure the fructose level in semen provide guidance in detecting possible blockages in the seminal ducts.
Semen culture: It is used to detect a possible infection in the semen sample.
Sperm function tests: These are tests to measure the fertilization ability of sperm.
Acrosome reaction test
ROS(reactive oxygen species) measurement
HBA (Hyaluronan Binding Test)
It is the most advanced test regarding sperm fertilization capacity in recent years.
Genetic Tests
Peripheral karyotype analysis: It is a numerical chromosome analysis. It is especially applied for the detection of extra or missing chromosomes (47XXY Klinefelter syndrome, etc.).
Y chromosome microdeletions: The absence of regions defined as AZFa and AZFb on the Y chromosome is used for their diagnosis. It is especially used to decide whether patients who have previously undergone TESE/TESA should undergo this operation again.

Hormonal (Endocrine) Tests

Measurement of blood levels of testosterone, LH, FSH and AMH hormones that regulate sperm production

Sperm Preparation Methods

Sperm preparation is performed in the andrology laboratory to remove sperm cells from the ejaculate fluid (semen) and isolate the cells.
Swim-up method: Separating sperm cells by floating them into culture fluids to increase fertilization ability.
Gradient method: It is the filtering of ejaculate using ready-made solutions containing microscopic sized silicon gel particles.
PICSI/spermslow method: It is the selection method of sperms that are mature and have no DNA breaks.
Microchip method: It is a method that has been popularly applied especially in recent times and in which not only the motile and normal sperms but also the sperms that have achieved DNA maturity are separated.