Understanding a Semen Analysis Report in Male Infertility

During ejaculation, Semen is released. Semen is the fluid that contains sperm in addition to other sugar and protein substances that are released. Semen Analysis is defined as a procedure carried out by fertility specialists who examine and evaluate the health, vitality, and overall quality of a man’s ejaculated semen and sperm. This procedure is also known as the sperm count test.  A semen sample is given in the lab and examined by a lab technician who checks for a number of aspects in the sample that could be the reasons that affect the overall fertility.

This examination of the semen sample is an important part of many fertility treatments, which will determine the various factors ranging from in vitro fertilization (IVF) and intrauterine insemination (IUI) to a general diagnosis of infertility.

In general, it is common to undergo two or three different sperm analysis tests. These tests are conducted to determine the sperm’s health. The duration of the tests conducted has to at least be seven days apart and has to be done during the course of two to three months. An average of the sperm samples taken will give the most conclusive result.

If you have been trying for over a year and have been having trouble getting pregnant, the first wise step would be to evaluate the fertility of both partners. Studies have shown that infertility occurs due to either of the partners, the male or the female who could be infertile. This blog will primarily focus on male infertility treatment involving sperm parameters. The Semen analysis test and report while far from perfect, serves as a guide and will be the deciding factor on to what type of treatment a couple could further proceed with to ensure they become parents in the future.

The male infertility test consists of a detailed semen analysis. The semen analysis will be able to track several parameters such as sperm count, sperm concentration, and sperm motility.

In comparison to various other tests used in the assessment of the infertile couple, the semen analysis report is considered to be a standardized test globally The standardization of measurement of sperm concentration and semen volume facilitates more accurate calculation of sperm output.

The amount of semen present, when a man ejaculates with the volume measured in volume, plays a vital role and has an impact on his ability to get his partner pregnant. The volume is measured in millilitres. According to the WHO, the normal measure should be greater than 2 milliliters; however, the lower reference limit and anything between 1.5 – 5 ml could also be considered normal.

A low semen volume could indicate a low amount of sperm, a partial or complete blockage or dysfunction in the seminal vesicles or prostate thus reducing the sperm’s ability to fertilize an egg. In contrast to this, an excess of fluid volume could also indicate the dilution of the amount of sperm present.

Sperm density or sperm concentration is a measure of the concentration of sperm in a man’s ejaculate and this means, Sperm density is the number of sperm present per milliliter of semen.

According to the WHO, a sperm count of 15 million/ml or above is considered to be adequate. Lower numbers of sperm count may indicate that the testicles are not producing adequate sperm the way they should, further resulting in a health condition called Oligozoospermia, a sign of male infertility.

The number of sperm present per milliliter of semen is known as the sperm count. The normal sperm count in the semen analysis should be between 20 million to over 200 million as low sperm count can make pregnancy difficult.

Total sperm count, or total sperm number, is defined as the total number of spermatozoa in the entire ejaculate.

The sperm’s ability to swim properly is known as sperm motility. Sperm motility is an important factor in the case of fertility as the sperm has to travel to fertilize an egg and if the sperm is unable to swim freely there are less chances to fertilize eggs.

Sperm motility measures the number of moving sperms and also calculates them based on their ability to move. Sperm motility has to be in the range of 40%-50%. A lower sperm number could indicate that the body is exposed to toxins such as cigarette smoking, and alcohol, and environmental factors such as exposure to certain chemicals at the workplace, substance use or use of recreational drugs, caffeine intake, and intake of some medications for certain ailments. Low motility can also be a result of hormonal problems or issues related to varicocele which is the varicose veins in the scrotum.

The term Morphology refers to the shape of the sperm and the anatomy of the sperm. Sperm Morphology has a significant impact on fertility. Studies suggest that more than 50 percent of abnormally shaped sperms are the cause of reduced fertility to a great extent. The lab tests that are conducted will help identify the abnormalities in the parts of the sperm namely in the sperm’s head, midsection, or tail. There is also a huge possibility that the sperm could be immature and thus unable to effectively fertilize an egg. Thus the percentage of normally shaped sperm is analyzed to determine male fertility. A reduced number of normally shaped sperm can diminish the likelihood of conception thus decreasing the chances of pregnancy.

Any issues concerning to the acidity or alkalinity of the semen can affect the health of the sperm.

pH level – The ideal semen pH level should be between 7.2 and 7.8. If there is a pH level higher than 8.0 it could indicate that there is an infection detected and if the pH level is less than 7.0 it could indicate that the semen specimen is contaminated or that the male’s ejaculatory ducts are blocked. pH level measures the acidity in the semen and a low pH level indicates that the semen is acidic, while a high pH level indicates it is alkaline. An abnormal pH can affect the health of the sperm and affects the sperm’s movement as well.

Fructose is a sugar present in semen. It helps nourish and provides energy to the sperm. Low fructose levels may affect the viability of the sperm and the absence of fructose may indicate a problem with the seminal vesicles.

Liquefaction Time – Normal semen is generally gel-like and comes out as a thick fluid for 20 minutes after ejaculation.  The semen eventually turns into liquid. The inability of the sperm to liquefy, within 15 to 30 minutes results in reduced fertility as the liquefaction helps sperm to move. Thus liquefaction time is the time taken by the semen before it becomes liquid. It usually takes about 20-30 minutes, however, if it takes longer or it does not become liquid at all, there’s a problem that needs attention.

Appearance – The color of the semen should be whitish to grey and opalescent in appearance. If there is a red-brown tint noted it could indicate the presence of blood and at the same time, a yellow tint could indicate jaundice or it could be due to a side effect of other medications.

With male infertility being the contributing factor to almost 40-45% of infertility-related cases, it’s highly imperative among couples to ensure that the male as much as the female gets tested to check his fertility potential. Understanding the male’s fertility levels can help eradicate a number of probabilities that have been identified as the cause of infertility in the couple.

Hence, Routine Semen Analysis is a must-test to diagnose male infertility and to determine other causes related to it which has to be addressed to ensure a safe and healthy pregnancy at the earliest.