A basic semen analysis checks quantity and movement, but it cannot see the hidden molecular damage inside the sperm. Unexplained Male Infertility requires a deep dive into oxidative stress and DNA integrity.
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In approximately 15% of infertile couples, the man's standard semen analysis (checking count, motility, and morphology under a microscope) comes back completely normal, yet the couple still cannot conceive, or the woman experiences recurrent miscarriages.
Think of a car: A basic analysis tells us the car has four wheels and the engine runs. It does not tell us if the steering wheel works or if there is gas in the tank. We must look deeper into the cellular engine of the sperm.
Reactive Oxygen Species (ROS) are unstable molecules produced by smoking, pollution, obesity, or internal infections. Excessive ROS physically attacks the outer membrane of the sperm, blinding it so it cannot bind to or fertilize the egg naturally.
A sperm might swim perfectly straight, but if the DNA packed inside its head is shattered or fragmented, the resulting embryo will stop growing within a few days or result in a miscarriage. Standard tests do not check the DNA.
For a sperm to naturally enter an egg, a small cap on its head (the acrosome) must burst open and release dissolving enzymes when it hits the egg's shell. Sometimes, the sperm reaches the egg but the acrosome fails to fire, leaving the sperm locked outside. This is invisible on a standard semen analysis.