When most think of problems with fertility, they tend to attribute the cause to the female partner. However, male infertility is responsible, directly or indirectly, for 60% of fertility-related issues in reproductive-age couples. Even considering this statistic, male infertility is still often under-evaluated or dismissed. Evaluating the male partner for infertility improves the precision of infertility diagnoses and the results of subsequent treatment and management.
Do men need to get their semen analyzed? Evaluating male fertility is a key piece in determining the best treatment path for acouple struggling to get pregnant. One of the important fertility tests for infertile couples is a semen analysis test. Also referred to as a sperm count test, a semen analysis encompasses more information than just a sperm count.
What Causes Male Infertility?
The main indicator of male infertility is the inability to impregnate a partner. There may be no other obvious symptom or sign. If you and your partner have not conceived a child after a year of regular, unprotected intercourse, it's time to visit a reproductive specialist who could identify underlying problems, such as hormonal imbalances, dilated veins around the testicles, or possible inherited disorders. Certain conditions or events may be associated with male infertility.
- History of genital infections or inflammation of the prostate
- Early or late onset puberty
- Hernia repair
- Injury to or torsion (twisting) of the testicles
- Genitals exposed to high temperatures
- Undescended testicles
Certain prescription medications may also place a male at risk. Discuss any new medications with a pharmacist.
How Is a Semen Analysis Done?
The steps involved in a Semen Analysis include:
- Collection of Semen: The patient provides a semen sample by masturbating into a sterile container. The sample should be collected after 2-7 days of sexual abstinence.
- Preparation of the Sample: The semen sample is allowed to liquefy for about 30 minutes at room temperature. The liquefied sample is then mixed to ensure that the sperm are evenly distributed.
- Evaluation of Quantity: The quantity of semen is measured by using a calibrated pipette. The volume of the semen is usually between 1.5 and 5 milliliters.
- Evaluation of Quality: The quality of the sperm is evaluated by examining the sample under a microscope. The sperm are assessed for their motility, morphology, and concentration.
- Motility Assessment: The motility of the sperm is evaluated by measuring the percentage of sperm that are moving and the quality of their movement.
- Morphology Assessment: The morphology of the sperm is evaluated by examining the shape and size of the sperm. Abnormalities in the shape of the sperm can affect fertility.
- Concentration Assessment: The concentration of the sperm is evaluated by counting the number of sperm in a specific volume of semen. A low sperm count can affect fertility.
- Other Tests: In some cases, additional tests may be performed, such as testing for the presence of white blood cells in the semen or testing for infections.
A semen analysis may need to be repeated to ensure accuracy and to monitor changes in sperm parameters over time. If there are any abnormalities in the initial semen analysis, a repeat test may be necessary.
- Information Learned Through Semen Analysis
Analysis of a semen sample involves more than just counting the number of sperm present. In fact, a semen sample normally contains less than 5% sperm. It includes mucus and other fluids that make up the healthy environment for the survival of the sperm within the male's ejaculate. A sperm analysis test usually provides the following information.
Sperm Concentration
The number of sperm found in one milliliter of semen is the sperm concentration number. There should usually be approximately 15,000,000 sperm/milliliter in a healthy sample. A low sperm concentration number may show an overall low sperm count and may indicate an unusually high ejaculate volume.
Sperm Motility
Motility is the percentage of sperm in a sample that moves. If the sperm are incapable of swimming up the female reproductive tract to meet the egg, fertilization will not take place. A healthy semen sample should include about 40 of the sperm capable of moving. A scale of zero to four measures movement rate, which should be a three or higher if showing proper movement quality.
Viability or Vitality
Semen analysis reveals the percentage of live sperm in the sample. This is sperm viability or vitality. If sperm motility is low, it is especially important to determine viability. There should be at least 50% of the sperm cells which are viable, but if more than half are immotile, it may require further testing to determine viability.
Morphology
Morphology speaks to the shape of sperm cells. The three portions of the sperm — the head, the midsection, and the tail — are measured, and the proportions between each are recorded. For the sperm to swim effectively and fertilize, at least 4% of sperm need to have a normal shape.
Liquefaction
Ejaculated semen is normally thick and gelatinous, which helps it adhere to the female cervix. It should liquefy in about 20 minutes to enable sperm to swim effectively. If there is a delay in the liquefaction, more testing is generally indicated. SSemen pH
This analysis measures how alkaline or acidic the semen is. A balanced solution is ideal, with seminal vesicle fluid being more alkaline and prostate fluids being more acidic. If the semen is too acidic, it may kill the sperm or impair fertilization. The pH of the semen sample should be between 7.2 to 7.8. Low semen pH usually goes hand-in-hand with other abnormal measurements, such as a low sperm count or a low volume of semen.
Diagnosing Male Infertility Through Semen Analysis
Any male with one or more health issues that lower the chances of his partner becoming pregnant may need evaluation for infertility. While there are many causes for infertility in men that can be hard to diagnose, most often, the problem is with sperm delivery or sperm production.
Diagnosis begins with a physical exam and a full history. An exam usually includes blood work and semen analysis, along with a visual and tactile exam of the male sex organs. The results of baseline blood work will determine the need for more tests.
Semen analysis is most often done at least twice. Abnormal sperm numbers or compromised motility may necessitate further sampling. Semen analysis does not test for sperm function but is the cornerstone of baseline laboratory evaluation for male infertility. Analysis of the semen may provide useful data from which a fertility prognosis or a diagnosis of infertility can be determined.
Low sperm numbers or even no sperm production doesn't indicate irreversible or permanent infertility. It may only illustrate a problem with the growth or delivery of sperm. More testing may further define the problem and suggest possible treatments.
Plan Your Semen Analysis Today
Sometimes all that's needed are lifestyle changes to improve sperm health, viability and increase sperm count. A few examples include:
- Get plenty of exercise and sleep
- Maintain a healthy weight
- If you smoke, stop
- Enjoy alcohol in moderation
- Support a diet rich in antioxidants with vitamin D and calcium supplements
Avoid underestimating the possibility of male infertility. A correct diagnosis is imperative when determining the best path to building your family. A detailed, precise medical history, physical examination, semen analysis, and other lab work are key to nailing down a diagnosis.
If twelve consecutive months of trying to conceive have been unsuccessful, it's time to see an endocrinologist specializing in reproduction. The doctors at Reproductive Gynecology & Infertility can diagnose and treat male infertility. Give them a call today!
