Semen Analysis

Semen Analysis

Semen is defined as the thick, white fluid released during ejaculation containing sperm. The semen test is also sometimes referred to as the sperm count. (1)

What is Semen Analysis?

Semen analysis is a laboratory test to evaluate male fertility. After a year of unprotected sexual activity, infertility is characterized as the inability to become pregnant. Infertility affects 15% of all couples who are of reproductive age. A thorough physical examination, full medical and sexual history, and semen analysis are used to diagnose male infertility. In roughly half of the cases of infertility, the male factor plays a role and contributes considerably.

Semen can be evaluated based on several characteristics:

  • total sperm count, 
  • fluid volume, 
  • sperm concentration and nature of spermatozoa
  • their vitality, motility and shape, and the composition of the secretions are also factors.

Detailed analysis of these factors may help determine the cause of male factor infertility (2).

How is the Semen Analysis done?

You will need to provide a semen sample for this test. Your healthcare provider will provide information on how to collect the sample. 

Sperm sample collection methods include masturbating into a sterile jar or glass.

Within 30 minutes, you must deliver the sample to the lab. If the sample was taken at home, keep it warm for transport by storing it in the inside pocket of your jacket. 

Within two hours of receiving the sample, a laboratory specialist should evaluate it. The results are more reliable the earlier the sample is analyzed.

The things that will be evaluated are listed below:

  • How sperm become solid and turn into liquid
  • Liquid thickness, acidity, and sugar content
  • Resistance to flow (viscosity)
  • Sperm movement (motility)
  • The number and structure of sperm
  • Semen volume (3)

What are normal results in semen analysis?

  • Normal volume varies from 1.5 to 5.0 milliliters per ejaculation. 
  • The number of sperm per milliliter ranges from 20 to 150 million. 
  • At least 60% of the sperm should have a normal shape and show normal forward movement (motility). 

Values within the normal range can vary slightly between laboratories. Ask your provider what your particular test results signify. 

The examples above demonstrate average measurements for these test findings. Different measurements or samples may be tested in some laboratories. 

How these values and other semen analysis findings should be interpreted is not totally apparent. An unusual result does not always indicate that a man’s ability to procreate is compromised. (4)

What are abnormal results? 

An issue with male infertility may be indicated by abnormal results. For instance, if a man’s sperm count is too high or too low, he might not be as fertile. Fertility may be impacted by the semen’s acidity and the presence of white blood cells, which could indicate an illness. The test could detect sperm with aberrant shapes or motions. 

However, there are many unanswered questions about male infertility. If anomalies are discovered, more testing may be necessary. 

The majority of these problems are not an obstacle for IVF . (5)

What should be done to improve male fertility and sperm quality? 

Male factor fertility can be increased by adopting healthy lifestyle practices such as quitting smoking, drinking less alcohol, eating well, exercising, lowering weight if obese, avoiding toxic lubricants during sexual activity, and monitoring scrotal temperature. 

Hypothalamic-pituitary insufficiency, primary testicular failure, or obstruction of the genital tract can all cause low or no sperm counts in the semen. 

Semen analysis can help in giving an accurate picture of a man’s fertility potential when combined with a complete physical examination and a full medical and sexual history. It can also help direct treatment for both the person and the couple seeking relief from infertility. (6)

Limitations of Semen Analysis

Semen analysis offers valuable insights into male fertility; however, it does not encapsulate the entire scope. The process merely captures a single moment in the fluctuating cycle of sperm production. Consequently, this snapshot may not accurately represent long-term sperm health. Additionally, the analysis concentrates on sperm count, motility, and morphology. Yet, it overlooks critical factors such as sperm DNA fragmentation, which can significantly affect fertility potential.

Moreover, results from semen analysis are subject to variability. Factors like stress, illness, or the method of semen collection can temporarily alter semen quality, leading to inconsistent findings. Furthermore, an abnormal semen analysis can signal potential underlying health concerns, including hormonal imbalances or varicocele. Despite this indication, the analysis falls short of diagnosing the root causes of infertility.

Important aspects not assessed by semen analysis:

  • Sperm DNA fragmentation
  • Overall sperm health over time
  • Root causes of infertility

Despite these limitations, semen analysis remains an indispensable initial step for evaluating male fertility. Should the analysis yield abnormal results, further examinations are crucial. These subsequent tests aim to uncover the underlying issues and forge a path towards the appropriate treatment.

Source:

Jequier, A. M. (2010). Semen analysis: a new manual and its application to the understanding of semen and its pathology. Asian journal of andrology, 12(1), 11.

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