All About Sperm

One of the easiest tests to have done when you've been trying unsuccessfully to conceive is to have your husband do a semen analysis (SA). Compared to what women have to go through to be tested for infertility, this is a breeze, but, many men aren't thrilled with it. I say to those men, suck it up, get it done, and find out if your sperm are ok because your wife will go through a lot more and worse tests than masturbating into a cup!

Here's what you need to know about SA:

How is it done?

• You will be told to avoid having sex for anywhere from 2-5 days to make sure your sperm count is at it's highest. After the timeframe they give you, you go to your doctor and are brought to either a private room or a bathroom to produce your semen sample. Sometimes, if you live close enough, they will allow you to collect at home and bring it in but it is recommended to produce at the office. If you collect at home, it must be at the clinic or lab within 1 hour and kept warm and out of sunlight in the meantime.

• Once you are in the room you will produce a sample through masturbating into a sterile cup they provide for you. Producing through masturbation is the most recommended way of testing for infertility. This way nothing can skew the results. If you're testing for sperm count after a vasectomy or after a vasectomy reversal, you are sometimes given the option to have sex but pull out before ejaculating or by using a special condom the doctor will provide for you to collect semen.

• After you've collected your sample, you hand it off to a nurse or put it in a heated storage area. They will give you full instructions on what to do after since time is of the essence.

What does it show?

• Volume: How much semen is in one ejaculation. (Normal is 2-5 mL)

• Sperm Count: How many sperm are present per 1 milliliter (mL) of semen in one ejaculation. (Normal is 20 million per mL or more. 0 if the man has had a vasectomy)

• Sperm Motility: The percentage of sperm that can move forward normally. (Normal is more than 50% showing normal forward movement after an hour)

• Sperm Morphology: The percentage of sperm that have a normal shape. (Normal is more than 30% having a normal shape)

• Liquefaction Time: The time it takes for semen to liquefy (Normal is about 20-30 minutes after ejaculation).

• pH: Measure of the low pH (acidity)or high pH (alkalinity) of the semen. (Normal is 7.1-8.0)

• White Blood Cell Count: They are normally no white blood cells in semen. (Normal is none present)

• Fructose Level: The amount of sugar in the semen that provides energy for the sperm.

What if something comes back abnormal?

• If your SA comes back abnormal they may send you for another to double check the results. They may also run other tests such as measuring the hormones testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), or prolactin. If the sperm count or motility is especially low, a biopsy of the testicles may be performed.

• Further testing includes sperm penetration (test to see if sperm can penetrate a hamster egg), testing for the presence of sperm anti-bodies, or a post coital test.

What causes sperm issues?

• Severe injury to the testicles,  orchitis, varicocele, Klinefelter syndrome, radiation treatment to the testicles, or diseases that can cause shrinking (atrophy) of the testicles (such as mumps).