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Andrology Laboratory and Reproductive Tissue Bank


Ashok Agarwal, Ph.D., HCLD
preparing a cryopreserved specimen


The Andrology Laboratory and Reproductive Tissue Bank at The Cleveland Clinic Foundation provides specialized tests and services to evaluate male infertility and help couples who are attempting to achieve a pregnancy. Our Laboratory offers referring physicians accurate, quantifiable results using the latest, most sophisticated technology available. Our personnel include only highly qualified and experienced laboratory technologists, all certified by the American Society of Clinical Pathologists. Our laboratory is CLIA certified by the Department of Health and Human Services and has received accreditation from the College of American Pathologists in conjunction with the American Society for Reproductive Medicine.

The laboratory tests offered include a comprehensive semen analysis using a computerized system which allows for the quality of the semen to be studied through multiple exposure videomicrography. Results are then analyzed by computer.

Other tests include: direct and indirect Immunobead testing to detect antisperm antibodies in serum, sperm or seminal plasma. Special stains can be utilized for the presence of sperm in azoospermic specimen. A post-vasectomy screen is available for those patients who have recently had a vasectomy.

Additional Services of this specialized laboratory include the processing of sperm for intrauterine insemination; providing frozen (cryopreserved) donor semen for artificial insemination; and sperm cryopreservation for patients prior to chemotherapy, radiation therapy, retroperitoneal lymph node dissection or vasectomy.

Pathology Certificate

Fertility Investigations

Tests marked with an * (asterisk) require an appointment, All others do not.

Computerized Routine Semen Analysis


The semen analysis provides the most comprehensive assessment of semen quality and is considered the initial step in the basic infertility work-up of a couple. The semen analysis includes a determination of sperm volume, pH, sperm concentration, total sperm count, percent motility, velocity, linearity, morphology, color and viscosity. Our computerized semen analysis system is among the most technologically advanced available and yields far more accurate, quantifiable results than manual methods.

Quantitation/Endtz Test

Endtz Test

The presence of high numbers of white blood cells (WBCs) in semen has been associated with male infertility. WBCs can be quantitatively estimated by Endtz test, a histochemical technique in which peroxidase-positive granulocytes (leukocytes and PMN cells) stain dark brown. The Endtz test allows clear differentiation of WBCs from other immature germ cells in semen.

Kruger's Strict Morphology Classification


Data indicates that normal sperm morphology is a significant predictor of pregnancy in in vitro fertilization. Sperm morphology can be assessed with a modified method of strict scoring developed by Dr. Thinus Kruger of the Tygerberg Institute, South Africa and the Jones Institute, Norfolk, VA. This determination only can be made by experienced laboratory personnel. It is a valuable aid in the evaluation of the infertile male.

Special Staining for Azoospermic Specimen


Nuclear fast red-picroindigocarmine stain is used to assess the presence or absence of sperm microscopically in azoospermic specimen, when no sperm were seen during a routine semen analysis. The sperm heads stain pink and tails stain green.
This test must be performed by experienced laboratory technologist.

Post Vasectomy Screen


This test is performed for the presence or absence of sperm after vasectomy surgery.

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Last Update : February 03, 2009
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American Center for Reproductive Medicine
The Cleveland Clinic
10681 Carnegie Avenue, X11
Cleveland, OH 44195 USA
Tel: (216) 444-9485
Fax: (216) 445-6049
E-mail: CRM@ccf.org