Dr. Aruna Ashok MBBS, MS OG, DNB OG
- Clinical Director
Aruna Ashok | 24 Mar 2022
During fertility treatment, several examinations and tests are performed to determine the underlying cause of infertility. The tests may widely range from blood tests to hormone level assessments. Sometimes, it may also include invasive procedures like laparoscopy and biopsy for the most appropriate diagnosis. A semen analysis test is one such assessment, which is often named a sperm count test.
Semen analysis is a test, which is typically suggested by the healthcare provider during fertility treatments. The test is used to examine the male fertility in detail. The test evaluates the sperm morphology (structure and shape), motility (swimming efficiency), semen volume, semen quantity and quality, and more. The results may help the healthcare provider to determine if any abnormalities in the sperm are the contributing factor for infertility. Depending on the results, they may personalize the treatment plans.
Before getting to know how the procedure works, let’s see how to prepare for it.
The initial step of preparing for the semen analysis test may include refraining from ejaculation. The refrainment should take place for a minimum of two and a maximum of five days, specifically before the test. Abstaining for more than a week may have a negative impact on the sperm’s motility. Hence, two to five days is ideal and suggested. Also, he should refrain from using harmful substances like tobacco, recreational drugs, and alcohol. This will ensure optimal sperm count and its quality.
Note that it is essential to inform your healthcare provider if you are taking any medications. This may sometimes impact the results of semen analysis.
Also, ensure to keep yourself well-hydrated and maintain a healthy lifestyle at least a few days before the test.
Let’s see how the procedure works.
The person will be asked to collect his semen in the sterile container provided by the healthcare facility. You may masturbate and collect the semen in the container without spilling even a bit of the sample. In addition, you should avoid using any lubricants or saliva while collecting the semen. Also, it is important to urinate and wash your penis properly before starting to collect the sample. This will ensure keeping the bacteria away from the skin as well as the collected semen.
Semen liquefaction is the natural process of keeping the collected semen at room temperature for about 20 to 30 minutes. This is done to liquefy the semen from a gel-like substance to a liquid state. This may help the healthcare specialist to analyse sperm health more accurately.
Microscopic examination is a significant step in the entire semen analysis procedure. The analysis is done under the microscope to determine the sperm count, motility, morphology and overall sperm health.
Additional parameters such as white blood cells, vitality, pH levels, and viscosity are determined in the microscopic evaluation. Furthermore, the presence of round cells, and sperm aggregation or agglutination are also been identified. These parameters play a crucial role in determining the potential cause of male infertility.
In general, the collected sample is tested preferably within 30 minutes to 1 hour. This is because the sperm may usually die shortly after coming out of the body. This may significantly impact the semen analysis results.
The following is some of the information on what to expect during the semen analysis test.
Many healthcare facilities, especially fertility clinics and laboratories, provide a private and comfortable room for masturbation and semen collection. They may also provide amenities like books and television to help with the process. In addition, some facilities may even suggest taking your partner to the semen collection room to provide a sense of comfort and emotional support.
The semen collection procedure is usually not a painful one. However, some individuals may feel anxious and embarrassed about the process, especially if it is their first time.
You will be given the proper instructions before collecting the sample by the healthcare professionals.
The waiting time for the report may usually vary from facility to facility. However, in general, the reports may be provided within a couple of hours.
Even though the reports are normal, your fertility specialist may suggest for follow-up analysis. Follow-up analysis is when multiple semen samples are collected from the individual within a few weeks for a semen analysis test. This is to ensure accuracy as the sperm count and quality may differ from day to day. Based on this, your fertility specialist may personalise the treatment plan.
The following is some of the information on what to expect during the semen analysis test.
The following are some of the analyses that are crucially made in semen analysis.
During semen analysis test, the sperm count may denote the presence of the total amount of sperm from the entire ejaculated semen. It includes both live and dead sperm. The normal sperm count may usually exceed 15 million sperm in each millilitre. If the numbers are below 15 million, it is widely referred to as the condition called oligozoospermia. Low sperm count can primarily contribute to infertility.
During semen analysis test, the sperm concentration may denote the presence of sperm in each millilitre of semen. In general, the normal sperm concentration may range anywhere between 15 and 200 million sperm in each millilitre. Generally, sperm concentration is measured per millilitre of semen.
Sperm motility is the determination of sperm movement. The analysis may indicate how well the individual’s sperm is active and able to swim in the forward direction. The sperm motility is assessed in three main categories, which may include progressive, non-progressive and immobile.
If the motility rate of the sperm exceeds 40%, it is then determined as normal. This may significantly indicate that the majority of the sperm have the ability to move. The percentage is optimal enough to achieve successful fertilization.
Sperm morphology is referred to as the shape and structure of the sperm present in the semen. The sperm morphology plays a crucial role in male fertility along with sperm count and sperm motility. A normal sperm morphology is determined when the sperm has an oval-shaped head, a long tail and a slender midpiece. Whereas abnormal sperm morphology is determined when there are any deviations in the shape and structure of the sperm when compared to normal morphology. For instance, abnormal sperm head, tail, and so on.
The normal semen volume is determined when the value ranges anywhere between 1.5 and 5.0 millilitres (mL) in every ejaculation. The lower value may indicate numerous disorders that are associated with the male reproductive system. Lower semen volume is determined when the individual’s ejaculation is consistently below 1.5 millilitres, which can be the contributing factor for male infertility.
A pH level in semen may be determined as normal when the value ranges between 7.2 and 8.0. This is due to the slight alkaline presence in the semen. This pH range may be an indication of healthy sperm function. A value below 7.2 or above 8.0 may suggest underlying health conditions like infections, blocked ejaculatory ducts, and so on. This may certainly be the contributing factor to male infertility.
The increased amount of white blood cells in the semen may significantly be a sign of infection or inflammation in the reproductive system of the male. This may contribute to affect fertility and sperm quality. The normal range of white blood cells in semen may range below 1 million per millilitre (mL).
The immune system in a man can indeed produce proteins. These proteins are most commonly called ASA or anti-sperm antibodies. These may be the contributing factors of male infertility as they may interrupt semen motility, morphology and even concentration. The normal range of anti-sperm antibodies in semen should be around 0 to 60 U/ml. The excessive amount may require medical intervention.
A semen analysis may evaluate sperm health and fertility by assessing several key parameters against WHO (World Health Organization) standards. This analysis can be the initial step to achieve valuable insights into male reproductive health. Normal results may be the indicators of no male infertility, while abnormal results may indicate a requirement for further investigation and treatment.
You need not panic even though the results are abnormal. The disorder can be treated through various techniques like assisted reproductive techniques (ART). Clinics like A4 Fertility Centre have skilled and experienced fertility specialists who are well-versed in ART. They ensure to provide personalized care for better possible outcomes, throughout the fertility journey.
1. Can I perform a semen analysis test at home?
The answer to the question is yes. There are several at-home semen analysis kits available in the market. You can collect the sample and test it at home without the need to go to the facility or laboratory. However, you may not get a detailed analysis from the at-home kits as in the lab test. They can only measure sperm count and sperm motility.
2. What are the reasons for sperm quality issues?
The quality of the sperm can be compromised for various reasons, which may include unhealthy lifestyle habits, medical conditions, or pollutants in the environment.
3. Is male infertility common in Chennai?
The answer to the question is yes. Male infertility is quite a common concern in recent times, and Chennai is not an exception. A study found that in India, approximately 15-20% of men experience infertility issues. This may certainly include men in Chennai.
4. Is male infertility curable?
There is no definite answer to the question. It is curable in certain scenarios, while it is not completely curable in others. However, the issue can be managed and treated efficiently to increase the chances of achieving conception. When it comes to fertility, the reproductive health of both the male and female partners is important.
5. Can I improve sperm health through food?
The answer to the question is certainly yes. You can enhance the health of sperm by consuming nutrient-rich foods like antioxidants, zinc-rich foods, folate, and omega-3 fatty acids in your diet. You can also start consuming dark chocolate, citrus fruits, oysters, walnuts, and leafy greens. These foods can significantly enhance sperm count and sperm motility, which are crucial for successful fertilization.
