Semen Analysis

Male factor infertility affects 40% of the couples. There are many causes for male infertility, including abnormal semen and sperm production, failure of sperm delivery and general health and lifestyle issues.

Male infertility is usually diagnosed first by a semen analysis but other test may be required to correctly diagnosis the cause. Semen analysis is a simple test. The semen sample is collected either at home or at the lab.

The lab analyses the semen sample for the following qualities.

Volume and physical characteristics of semen

Semen is normally translucent or whitish-gray opalescent in color. Semen that is yellowish, greenish, reddish, or brownish, as well as semen that is too thick or watery or carries a foul odor, can prevent sperm from achieving fertilization. Abnormal semen can be caused by infections, diseases, and other causes.

Most men ejaculate between 2.5mls and 5mls of semen and lower semen volumes can result in fertility problems for couples. Smaller semen volumes can impact fertility because there is an inadequate amount of fluid to bring the sperm in contact with the cervix and allow the movement of the sperm toward the fallopian tube to meet and fertilize the egg. Occasional low semen production may be normal; however, consistently low volume needs to be treated. Low semen volume has several causes, including:

• Blockages in a seminal vesicle or ejaculatory duct, sometimes due to a varicocele
• Retrograde ejaculation, a condition in which part or all of the semen flows backwards into the bladder
• Infections
• hormonal abnormalities

If the low semen volume is due to a blockage it can be treated through surgical procedures to eliminate blockages or with antibiotics to clear up infections. However in some cases when the cause of low semen volume cannot be successfully treated there are a variety of infertility treatments, including sperm retrieval and artificial insemination, which can help a couple successfully conceive.

Concentration (number of sperm per milliliter of semen)

A normal sperm count is considered to be 20 million per milliliter of semen. Low sperm count, also known as oligospermia, is a very common cause of male factor infertility. A low sperm count is characterized as less than 20 million sperm per milliliter of semen. Male factor infertility due to oligospermia can be caused by a variety of factors including:

• Stress
• Smoking and drug use
• Obesity
• Nutritional deficiencies.
• Hormonal
• Varicocele
• Previous surgeries or injuries to the testicles
• Missing part of the “Y” chromosome

Motility (percentage of moving sperm)

Low sperm motility is a male infertility condition in which sperm’s ability to swim or penetrate an egg is diminished. More than 60% of sperm should be motile for normal fertility, but even men whose motile sperm constitutes only about a 30% of the total sperm count may be able to cause a pregnancy. In men with low sperm motility, fewer than 8 million sperm per milliliter show normal movement. When the sperm motility is abnormal many times there are other abnormalities also such as asthenozoospermia and necrozoospermia.

Couples demonstrating this type of male factor infertility may want to consider advanced treatment such as intrauterine insemination or intracytoplasmic sperm injection.

Morphology (sperm shape)

Male factor infertility can be caused by sperm with an abnormal shape or size. Abnormally shaped sperm can prevent normal motility and egg penetration, which results in infertility. Common sperm abnormalities include sperm with an overly large or too-small, tapered, or crooked heads, two heads, or a tail with kinks. A normal semen analysis using the current strict morphology standard should show greater than 6% normal sperm shape.

Fortunately abnormally shaped sperm just don’t work and are thought to be unable to fertilize an egg or create a viable pregnancy. They do not appear to cause chromosomal abnormalities in embryos. Abnormally shaped sperm may have a greater effect on male infertility than sperm motility does; however, treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF) offered at our practice can help couples with this problem achieve successful pregnancy.