Semen or sperm analysis is an essential part of male fertility tests. The procedure involves testing the various properties of a man’s semen and sperm cells to assess reproductive wellbeing. Since around 15% of couples worldwide suffer from infertility, with a significant share of this being male-related, understanding semen analysis and its findings is of utmost importance to potential parents. This post explains the finer points of semen analysis: what the tests measure, why they matter, and how you can read the result.
What is Semen Analysis?
Semen testing is a test carried out by the lab to determine the purity and quantity of a man’s semen and sperm. It is often administered to a couple who find it difficult to get pregnant after one year of unprotected intercourse (or six months if the woman is over 35). The analysis tells us much about sperm biology and male fertility.
Usually, the semen is harvested via masturbation into a sterile container, though some clinics even allow collection via coitus interruptus (withdrawal). Once obtained, the sample is sent to a lab for testing, and there it undergoes several tests.
Parameters Evaluated in Semen Analysis
There are many parameters evaluated during semen analysis, all of which add up to a broad picture of male fertility:
1. Volume
A sample volume is a key indicator of semen analysis. According to the World Health Organization (WHO), a normal semen volume is between 1.5 and 5.0 millilitres per ejaculate. Semen volume can be an indicator of many reproductive health issues. Low volumes can reflect hormonal changes, a blockage of a duct, or retrograde ejaculation, in which semen flows backward into the bladder instead of outward on ejaculation. Low volume is also indicative of problems with sperm production in the testis, which requires further investigation to pinpoint the underlying cause.
In contrast, elevated semen volumes do not equate to improved reproductive health. Too much fluid may lower sperm concentration and impact fertility. Volume, then, is only one of a number of factors to consider as part of a semen analysis.
2. Sperm Concentration
Sperm concentration describes how many sperm there are in one milliliter of semen. By the WHO standard, a normal level of sperm counts would be over 15 million sperm per millilitre. Low levels of sperm concentration (oligospermia) can significantly reduce fertility, making it difficult to have children. Low sperm counts can be caused by hormones, environmental toxins, or medical conditions such as varicocele (large veins in the scrotum).
A full sperm concentration measurement also accounts for total sperm count, which is defined as dividing the sperm count by the volume of the ejaculate. This figure provides a more detailed picture of how much sperm is available for fertilisation.
3. Motility
Sperm motility includes both the proportion of moving sperm in a specimen and the degree of movement. Sperm must swim efficiently through the female tract to get to the egg and fertilize it. (The WHO defines normal motility as having 40% or more motile sperm.) Poor motility, or asthenozoospermia, can be the outcome of infections, hormonal deficiencies or structural defects in the male reproductive tract.
Motility is further subdivided into progressive motility (sperm that moves forward in a straight line) and non-progressive motility (sperm that does not move). Having knowledge of both forms of motility allows physicians to evaluate the sperm’s functional ability.
4. Morphology
Sperm morphology consists of size and shape, key traits that affect the way sperm function. Ordinary sperm must have an oval head and a long tail to move towards the egg. According to the WHO guidelines, at least 4% of a sample’s sperm needs to be normal in morphology for it to count as healthy. Normal sperm anatomy, or teratozoospermia, can prevent sperm from successfully binding to and entering the egg, and therefore hindering fertilization.
What affects the shape of sperm can be attributed to lifestyle factors – diet, smoking, drug use, etc – or to genes and environmental factors. An abnormal morphology is generally something to look into because it might reflect health problems that need to be addressed.
5. pH Level
The pH value of the semen is another important aspect of a semen test. In general, healthy semen has a pH of 7.2-8.0, and is somewhat alkaline. Abnormal pH — too low (acidic) or too high (alkaline) — can indicate infections or other conditions that affect sperm viability and motility. Low pH, for example, could indicate a urinary tract infection, while high pH indicates a problem with the prostate or seminal vesicles. A constant monitoring of pH will ensure that potential infections or reproductive health issues are detected and managed accordingly.
6. White Blood Cell Count
White blood cells (WBCs) in semen can be a sign of inflammation or infection in the male reproductive tract. On average, a semen test detects less than 1 million WBCs per millilitre. Increased WBC levels may be indicative of prostatitis or STIs, both of which have a major impact on the sperm quality and fertility. Determining abnormal white blood cells is essential for the evaluation of overall reproductive function and treatment planning.
7. Fructose Level
Fructose, a sugar found in seminal fluid, is a fuel for sperm. Low levels of fructose can be a sign of problems with the seminal vesicles that manufacture this fluid. The lack or excess of fructose in the semen can compromise sperm motility and ultimately interfere with fertility. Therefore, the detection of fructose in a semen analysis is an important way to determine both sperm quality and the fertility of the reproductive system.
Interpreting Semen Analysis Results
Semen analysis results are very finely-grained and should be analysed by a medical professional. Below, we provide a snapshot of the key findings you’ll come across:
Normal Results
In cases where all of the measurements are within normal limits, fertility is generally in good shape. But even a good test cannot guarantee successful conception, and may include female factors or other problems.
Abnormal Results
Abnormal findings indicate a number of fertility disorders:
Oligospermia (Low Sperm Count): It can be treated through lifestyle modifications, medications, or assisted reproduction.
Azoospermia: The absence of any sperm in the semen indicates severe conditions that will require further investigation or treatment such as surgical extraction or donor sperm.
Asthenozoospermia (Poor Motility): This may be managed with lifestyle adjustments and sometimes assisted reproductive technology, such as ICSI (Intracytoplasmic Sperm Injection).
Teratozoospermia (Abnormal Morphology): Sperm that have abnormal shapes can be difficult to fertilize. There are alternatives – managing internal conditions or using assisted reproduction.
Additional Factors
While semen analysis does encompass important information, it does not alone tell you how fertile a man is. It is influenced by other factors – hormonal, sexual and overall health. This is why doctors may order additional testing and diagnostic procedures based on semen analysis.
How to Live Your Life To Boost Semen Quality?
Men interested in boosting their fertility can make a huge difference in the quality and number of sperm when they live a healthy lifestyle. Consider implementing the following changes:
Diet and Nutrition: A proper diet that is high in antioxidants, vitamins, and minerals can enhance your health. Foods such as fruits, vegetables, nuts, and whole grains can be especially beneficial.
Exercise: Staying healthy with consistent exercise will help regulate hormonal levels and enhance the health of sperm.
Limit Alcohol and Avoid Smoking: Alcohol and smoking negatively impact sperm production and movement. Eliminating or reducing these substances can be helpful.
Manage Stress: Stress can affect hormones and fertility. You can relieve stress through mindfulness, yoga or other stress reduction methods.
Avoid Environmental Toxins: Having the exposure to some environmental toxins such as heavy metals, pesticides, and heat (i.e., from hot baths or tight clothes) will disrupt the production of sperm.
Conclusion: Semen Analysis And Test Results
Semen analysis can be a crucial resource in determining male fertility and assisting couples struggling with conception. Once all semen metrics are analysed, physicians can diagnose potential fertility problems and provide solutions. To make things better, men can take their reproductive health into their own hands and make lifestyle changes that will increase their likelihood of having a successful conception. For questions about fertility or semen testing, speak to a physician with reproductive health expertise for individual support.
