Semen Analysis
How To Prepare
How It Is Done
How It Feels
Risks
Semen Analysis Results
What Affect the Tests
What to Think About
Semen Analysis
A semen analysis measures the amount of semen a man produces and
determines the number and quality of sperm in the semen sample.
A semen analysis is done to determine whether:
- A man has a reproductive problem that is causing infertility.
- A vasectomy has been successful.
- The reversal of a vasectomy has been successful.
A semen analysis is usually one of the first tests done to help
determine whether a man has a problem fathering a child
(infertility). A problem with the semen or sperm affects more than
one-third of the couples who are unable to have children
(infertile).
Tests that may be done during a semen analysis include:
- Volume. This is a measure of how much semen is present in one
ejaculation.
- Liquefaction time. Semen is a thick gel at the time of ejaculation
and normally becomes liquid within 20 minutes after ejaculation.
Liquefaction time is a measure of the time it takes for the semen to
liquefy.
- Sperm count. This is a count of the number of sperm present per
milliliter (ml) of semen in one ejaculation.
- Sperm morphology. This is a measure of the percentage of sperm that
have a normal shape.
- Sperm motility. This is a measure of the percentage of sperm that
can move forward normally. The number of sperm that show normal
forward movement in a certain amount of semen can also be measured
(motile density).
- pH. This is a measure of the acidity (low pH) or alkalinity (high
pH) of the semen.
- White blood cell count. White blood cells are not normally present
in semen.
- Fructose level. This is a measure of the amount of a sugar called fructose in the semen. The fructose provides energy for the sperm.
How To Prepare
You may be asked to avoid any sexual activity that results in
ejaculation for 2 to 5 days before a semen analysis. This helps
ensure that your sperm count will be at its highest, and it improves
the reliability of the test. If possible, do not avoid sexual
activity for more than 1 to 2 weeks before this test, because a long
period of sexual inactivity can result in less active sperm.
You may be asked to avoid drinking alcohol for a few days before the
test.
Be sure to tell your health professional about any medications or
herbal supplements you are taking.
How It Is Done
You will need to produce a semen sample, usually by ejaculating into
a clean sample cup. You can do this in a private room or in a
bathroom at your health professional's office or clinic. If you live
close to your health professional's office or clinic, you may be
able to collect the semen sample at home and then transport it to
the office or clinic for testing.
The most common way to collect semen is by masturbation, directing
the semen into a clean sample cup. You can collect a semen sample during sex by withdrawing your penis
from your partner just before ejaculating (coitus interruptus). You
then ejaculate into a clean sample cup. This method can be used
after a vasectomy to test for the presence of sperm, but other
methods will likely be recommended if you are testing for
infertility.
You can also collect a semen sample during sex by using a condom. If
you use a regular condom, you will need to wash it thoroughly before
using it to remove any powder or lubricant on it that might kill
sperm. You may also be given a special condom that does not contain
any substance that kills sperm (spermicide). After you have
ejaculated, carefully remove the condom from your penis. Tie a knot
in the open end of the condom and place it in a container that can
be sealed in case the condom leaks or breaks.
If you collect the semen sample at home, the sample must be received
at the laboratory or clinic within 1 hour. Keep the sample out of
direct sunlight and do not allow it to get cold or hot. If it is a
cold day, carry the semen sample container against your body to keep
it as close to body temperature as possible. Do not refrigerate the
semen sample.
Since semen samples may vary from day to day, 2 or 3 different
samples may be evaluated within a 3-month period for accurate
testing. A semen analysis to test the effectiveness of a vasectomy is usually
done 6 weeks after the vasectomy.
How It Feels
Producing a semen sample does not cause any discomfort. However, you
may feel embarrassed about the method used to collect it. If
masturbation is against your religious beliefs, discuss alternate
methods of collection with your health professional.
Risks
There are no risks associated with collecting a semen sample.
Semen Analysis
Results
A semen analysis measures the amount of semen a man produces and
determines the number and quality of sperm in the semen sample.
Results of a semen analysis are usually available within a day.
Normal values may vary from lab to lab.
- Normal: 1.0-6.5 milliliters (ml) per ejaculation
- Abnormal: An abnormally low or high semen volume is present, which may sometimes cause fertility problems.
- Normal: Less than 60 minutes
- Abnormal: An abnormally long liquefaction time is present, which may indicate an infection.
- Normal: 20-150 million sperm per milliliter (mL). 0 sperm per milliliter if the man has had a vasectomy
- Abnormal: A very low sperm count is present, which may indicate infertility. However, a low sperm count does not always mean that a man cannot father a child. Men with sperm counts below 1 million have fathered children.
- Normal: At least 70% of the sperm have normal shape and structure.
- Abnormal: Sperm can be abnormal in several ways, such as having two heads or two tails, a short tail, a tiny head (pinhead), or a round (rather than oval) head. Abnormal sperm may be unable to move normally or to penetrate an egg. Some abnormal sperm are usually found in every normal semen sample. However, a high percentage of abnormal sperm may make it more difficult for a man to father a child.
- Normal: At least 60% of the sperm show normal forward movement. At least 8 million sperm per milliliter (mL) show normal forward movement.
- Abnormal: Sperm must be able to move forward (or "swim") through cervical mucus to reach an egg. A high percentage of sperm that cannot swim properly may impair a man's ability to father a child.
- Normal: Semen pH of 7.1-8.0
- Abnormal: An abnormally high or low semen pH can kill sperm or affect their ability to move or to penetrate an egg.
- Normal: No white blood cells or bacteria are detected.
- Abnormal: Bacteria or a large number of white blood cells are present, which may indicate an infection.
- Normal: 300 milligrams (mg) of fructose per 100 milliliters (ml) of ejaculate
- Abnormal: The absence of fructose in the semen may indicate that the man was born without seminal vesicles or has blockage of the seminal vesicles.
Certain conditions may be associated with a low or absent sperm
count. These conditions include orchitis, varicocele, Klinefelter
syndrome, radiation treatment to the testicles, or diseases that can
cause shrinking (atrophy) of the testicles (such as mumps).
If a low sperm count or a high percentage of sperm abnormalities are
found, further testing may be done. Other tests may include
measuring hormones, such as testosterone, luteinizing hormone (LH),
follicle-stimulating hormone (FSH), or prolactin. A small sample
(biopsy) of the testicles may be needed for further evaluation if
the sperm count or motility is extremely low.
What Affects the Test
Factors that can interfere with your test or the accuracy of the
results include:
- Medicines, such as cimetidine (Tagamet), male and female hormones (testosterone, estrogen), sulfasalazine, nitrofurantoin, and some chemotherapy medicines.
- Caffeine, alcohol, cocaine, marijuana, and smoking tobacco.
- Herbal medicines, such as St. John's wort and high doses of echinacea.
- A semen sample that gets cold. The sperm motility value will be inaccurately low if the semen sample gets cold.
- Exposure to radiation, some chemicals (such as certain pesticides or spermicides), and prolonged heat exposure.
- An incomplete semen sample. This is more common if a sample is collected by methods other than masturbation.
- Not ejaculating for several days. This may affect the semen volume.
What To Think About
Consistently detecting sperm in the semen of a man who has had a
vasectomy indicates that his surgery was not successful, and another
form of birth control should be used to prevent pregnancy. A low
number of sperm may be present in a semen sample taken initially
after a vasectomy. However, sperm should not be present in
subsequent samples.
A man whose mother took the medicine diethylstilbestrol (DES) during her pregnancy with him has a greater-than-normal risk of being unable to father a child (infertile).
Additional tests may include measuring hormone levels, such as testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), or prolactin. Other fertility testing, including sperm penetration, the presence of antisperm antibodies, or analysis after sexual intercourse (postcoital), may be recommended for infertility problems.
Contact Legacy Male Health Institute, P.A about our male infertility testing service in Dallas, Ft Worth, Plano, North Dallas, Irving & Las Colinas areas.
