Whether an issue involving the male is contributing to infertility or not, it is always advised that men have their semen analyzed when a woman is not getting pregnant naturally. After all, if the couple is seeking medical help for conceiving, a doctor will want to rule out any contributing issues from the male. It takes two to tango, as everybody knows.

What to expect with semen analysis

To produce a sample that can provide baseline results, the male is expected to refrain from ejaculating for two to five days prior to producing a test sample. The semen sample is then produced through masturbation and collected in a sterilized cup provided by a physician or by catching the semen in a specialized condom.

The sample must be analyzed within the hour, so the sample is often produced at the physician’s office in a private room. If done at home, the sample must be kept warm and still make it to a laboratory within the hour. It should be noted, as well, it is standard procedure to repeat the test after a month or more in order to confirm any findings.

What doctors look for with a basic semen analysis

Doctors can learn a lot from a semen analysis. Here’s what they look for from standard testing:

– Sperm count – the total sperm count and the number of sperm per millimeter (the density) of sperm are both of interest

–  Semen volume

–  Sperm vitality and motility – how well the sperm cells move

–  Sperm size and shape – to assess the number of healthy-looking sperm

–  Semen pH – normal is semen that is slightly alkaline

–  Sperm antibodies – presence of a protein that is unhealthy for sperm

–  White blood cells – which indicates an infection is present

–  Viscosity – the thickness of the semen

–  Coagulation v. liquidity – how fast the semen goes from a thick to a thin viscosity

What do the numbers mean?

Volume

The volume of semen tells doctors if there is enough sperm to promote normal conception. Small amounts of semen indicate small amounts of sperm. The normal range is between 1.5 and 5 milliliters of fluid per ejaculation.

Viscosity

Semen, when ejaculated, is a relatively thick substance. After about 20 minutes, it should become more liquid. If it does not, this might make it difficult for the sperm to reach the egg.

Sperm count and density

Normal sperm density is around 20 million sperm per milliliter. Below 15 million is considered an infertility risk. Above 39 million (total) per ejaculation is considered healthy.

Motility

This is measured by the percentage of actively moving sperm. An hour after the sample is produced, 40 percent or more of the sperm should still be active and moving in a straight line. They should also be moving at a reasonable speed.

The activity is graded 1 through 4 with 1 being inactive sperm and 4 being the most active. If the numbers are low, the lab will conduct a sperm viability test to determine the number of inactive (dead) sperm.

Sperm vitality is the percentage of live sperm. Above 58 percent is healthy.

Morphology

In a healthy sample, at least 4 percent to 14 percent are deemed of “normal form” or NF. This is an analysis that looks at sperm shape, size, and length. Sperm is visibly defined as having a head, a midsection, and a tail. Abnormalities of these in large numbers can be the reason for infertility.

Semen pH

This tests alkalinity versus acidity. Normal is between 7.2 and 7.8 – slightly alkaline. Too low indicates an infection; too high indicates urine contamination or obstruction of ejaculatory ducts.

Fructose count

Fructose is sugar. Normal is close to 150 milligrams per deciliter or higher.

White blood cells

No more than 1 million cells per milliliter are considered normal.

Sperm antibodies

This is indicated by counts of how many sperms are joined together. Clumping in a consistent pattern suggest the presence of anti-sperm antibodies. Irregular clumping indicates a potential bacterial infection.

What next?

Various substances, including tobacco, caffeine, alcohol and several recreational and prescription drugs can affect sperm counts. Some herbal medications could be contributing factors, as well. All these factors should be discussed with your physician.

Additional tests

Doctors may also order additional tests to determine the cause of infertility if the first round of tests is inconclusive.  If you are interested in setting up a consultation at PRC to discuss infertility treatment, contact us today.

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