For couples struggling to conceive, it’s recommended to seek the help of reproductive specialists. Diagnosing the cause(s) of infertility involves a range of testing done on both partners.
For men, one of the first and most common tests done during a male fertility evaluation is a semen analysis.
What is a Semen Analysis?
When a doctor orders a semen analysis, or sperm count test, the lab tests the quality and quantity of semen and sperm. In addition to determining the number of sperm in the semen, or ejaculate, this test analyzes the health and viability of a man’s sperm. The three main factors of sperm health that are measured and analyzed are:
- The total number of sperm in the semen sample
- The shape of the sperm produced
- Sperm motility, or the movement of the sperm
Reproductive specialists will frequently conduct two or three sperm analysis tests if the results are abnormal to get a clear picture of the sperm’s health. If the results are normal for all parameters, then one test is sufficient.
What Does Semen Analysis Assess?
Semen analysis tests for the number, shape, and mobility of the sperm, but that isn’t the total extent of the information obtained. Other factors that can be considered in a semen analysis include:
- Total sperm count. The total number of sperm present in the sample. The average normal sperm count is 33 to 46 million sperm.
- Semen volume. The amount of ejaculate present, measured in milliliters.
- Sperm concentration. Measures the number of sperm present in 1 milliliter (mL) of ejaculate.
- Sperm vitality. The percentage of live sperm.
- Semen pH. Determines the acidity of the semen sample. If the semen is too acidic, it can kill sperm.
- Time to liquefaction. This measures the time it takes for semen to change from thick to a liquid consistency (a natural process.) On average, this takes 20 to 30 minutes.
- White blood cell count. Measurement of how many white blood cells are present in the semen sample. A very high count indicates an infection.
- Sperm morphology. The size and shape of sperm cells. In general, healthy sperm should have an oval head with a long tail. Sperm with abnormal shapes, such as having a large or misshapen head, a double tail, or a bent tail, are considered to have poor morphology. Poor sperm morphology can affect a man’s fertility and his partner’s ability to conceive. Abnormal sperm are less likely to reach the egg and fertilize it, leading to a lower pregnancy rate.
Analysis of a semen sample also evaluates the motility of the sperm.
- Percentage motile. This is the percentage of all the sperm that are moving in a single sample.
- Percentage motile concentration. The percentage of sperm in one measurement of semen that are moving. This is usually reported as millions of cells in one milliliter.
- Total motile sperm count (TMSC). This value is one of the most relevant to male fertility prognosis. It measures how many sperm are swimming in a single sample.
- Average path velocity (VAP). This value measures the speed at which sperm moves.
For a semen sample to be considered normal, at least 40% of the sperm present in the semen should be moving, or motile. Of that number, at least 32% of the sperm should demonstrate forward movement.
Semen analysis yields a great deal of information from a sample, but how do reproductive specialists base their decision to recommend this testing?
Who Needs a Semen Analysis?
When a couple has difficulty getting pregnant, both partners need to undergo testing to determine the cause. A semen analysis test will help the reproductive specialist to determine if a man is infertile or having difficulty producing adequate numbers of viable sperm. Testing can decide if a low sperm count or sperm dysfunction is the underlying cause of the couple’s infertility.
Semen analysis is also used to determine the success of a vasectomy procedure. When a man elects to undergo a vasectomy, the tubes that connect the testicles to the penis through which the sperm travel are severed and sealed. Cutting the tubes (vas deferens) is a permanent form of birth control. After a vasectomy, it is usually recommended that a man undergo a sperm analysis test once a month for three months to make certain there are no sperm present in his semen anymore.
Collecting a Semen Sample
Your reproductive specialist will instruct you on the preparation for collecting a semen specimen. These are instructions you’ll need to follow to the letter to ensure accurate results. In general, the following guidelines apply when preparing for a semen analysis.
- Abstain from ejaculation for 48 hours before your test.
- Avoid caffeine, alcohol, and recreational drugs such as marijuana and cocaine for two to five days.
- Avoid taking any herbal medications as instructed by your reproductive specialist.
- Discuss your other medications with your care provider to determine what is safe to take and what you should withhold for a short time.
Your reproductive specialist will discuss the instructions for actually collecting your semen specimen. This can sometimes be done at home, or you may be asked to provide the specimen while at the clinic.
Possible Issues with Sampling
No recognized risks are associated with collecting or testing a semen specimen. There are some factors that may negatively impact the outcome of a test.
- If the semen comes into contact with a spermicide, it may compromise the analysis results.
- Collecting a specimen when you’re stressed or ill may skew the results.
- The sample could become contaminated during collection or testing.
- Lab technician error is a possibility.
If you follow the instructions of your reproductive specialist closely, your chances of a faulty test and invalid results are minimal.
What Comes Next?
If the results of one test are abnormal, that doesn’t mean your male fertility is impaired. Many factors can lead to poor results, such as stress over the test or a recent illness. Should your results be abnormal, your reproductive specialist will discuss repeating the test in a few weeks.
Once you have valid results from a semen analysis, your reproductive specialist will discuss the next steps for you and your partner. From possible causes for the poor results to what treatments are available, your specialist will discuss the options in depth with you.
To get started on your road to becoming parents, or to obtain more information, contact us to set up an appointment with one of their reproductive specialists.