After sitting in the waiting room, walk down the corridor to the dressing room and put on the scrub-I was told later that for most men, this feels like a "road of shame". This of course makes me a little anxious. It inspired a seemingly inevitable thought: "Do I have any problems?"

I am visiting Trinidad and Tobago’s IVF and Fertility Center in Maraval, where I met with scientific director and embryologist Natalie Jess, as well as fertility nurse, andrology technician, blood collection technician and patient support team coordinator Gabrielle Rodney sat together.

Moreover, as a man, I gained first-hand experience in sperm analysis.

When asked how I felt, I told Rodney, "I will definitely work hard to prepare mentally for any stories that may happen here."

Marshelle Haseley of the Andrology Laboratory of Trinidad and Tobago IVF and Fertility Center-

Obtaining samples, I take it for granted, this is the easiest part, according to Rodney, in fact, sometimes for many men, this is another challenging part of the emotionally huge process.

She said that even making samples can mean 30 minutes or as much as an hour of tension. For most men, even a visit to the center will only happen after a period of challenge of conception. Jess and Rodney said that in most cases, men come after trying to conceive for a while, and the sperm test is not the first test.

Rodney said the reluctance to be tested may have a lot to do with the culture of the region - and the idea that imperfect sperm health may be related to being "a real man."

When asked whether the center has internal psychotherapists to help men deal with the tremendous psychological stress in this process, Jess said that men have been arranged to talk with therapists, especially if treatment like IVF becomes an option.

Jess said that waiting usually exacerbates the anxiety that men experience. Unlike my experience with testing, men usually provide their samples and wait for the results for a few days.

Rodney said that the number of sperm and their physical characteristics help determine the health of the sperm.

She explained the three basic parts of sperm; the head of the cell nucleus containing the genetic code/DNA is covered with enzymes that can dissolve the acrosome; the middle part contains the energy-producing mitochondria; and the last part is the tail of the propeller.

The room where it occurs: Andrology laboratory is a place where tests are conducted to detect diseases or conditions specific to men. -Photo by Marshall Hasley

Rodney said that the health of sperm also depends in part on the average number of semen without defects in these physiological parts. It is normal for men to find defects in certain sperm.

"When performing sperm analysis, we will check the number of sperm; the motility count, which refers to its swimming ability; and check the shape. These three tests can determine whether the sperm is normal or whether there is a problem."

In addition, she said: “Volume is very important. Small size may mean obstruction, while very large volume may mean overactive spermatic glands. Normal volume is between 1.5 and 5 milliliters.”

She added that the sample should not be clear.

One of the misunderstandings they eliminated is that sperm retention is good for sperm health. Conversely, Jess said, sperm produced and retained for five days or longer are more likely to break in the double helix, and fresh sperm produced recently are of the best quality.

Then put the sample into the counting chamber, which gives information on the number of sperm per milliliter and the rate of movement. This is done by observing the sperm under a microscope.

Jess walked in and saw Rodney click on the counter, and the sperm was moving downstream of the microscope. I was relieved to hear that it was a good sign. Observing sperm under a microscope for the first time is surreal.

Gabrielle Rodney performs a sperm count test in the Andrology Laboratory of Trinidad and Tobago's IVF and Fertility Center-Photo by Marshelle Haseley

The second test involves testing the sample with anti-sperm antibodies, which test the sperm's resistance and ability to bind to eggs. It may also indicate possible causes of problems such as infection or injury.

The third test is to check the morphology, which basically means checking the consistency of healthy sperm, all of which are intact, proportionate and functioning normally. In some cases, certain parts of the sperm are underdeveloped or missing. Rodney said that, on average, if a quarter of the sperm in 200 samples are healthy, there is nothing to worry about.

Jess also explained that there is also a test called sperm fragmentation, which analyzes possible breaks in the double helix structure of DNA (molecules that carry genetic information), which often leads to infertility.

This analysis shows how important it is to find out the causes of fertility problems and solve them, even though it can be traumatic for men.

The above article is author Marshelle Haseley's summary of male infertility in Trinidad and Tobago. See his report link https://newsday.co.tt/2021/07/18/men-take-a-sperm-test-why-male-infertility-is-high-in-trinidad-and-tobago/