SEMEN ANALYSIS – WHAT YOU NEED TO KNOW

The sperm

This is the male reproductive cell. When the sperm enters the egg and they fuse together (a process called fertilization) an ‘embryo’ is produced and the embryo grows to become the baby. Each sperm has a head, mid piece and a tail. There are two types of sperm – an ‘X’ carrying sperm and a ‘y’ carrying sperm, X and Y are chromosomes which determine the sex of your baby. If the x carrying sperm fertilizes the egg a female baby is formed and if the y carrying sperm fertilizes the egg a male baby is formed.

Sperms are present in a fluid called the ‘seminal fluid’. This fluid is secreted by nearby glands. Sperms are normally present in large numbers (more than 20 millions) and have the capacity to move forward actively towards the egg with the help of their tails. Though they are normally present in large numbers only about hundred or so manage to reach the egg and only one sperm finally fuses with the egg. Most of the sperms are therefore lost in the vagina due to acid secretions. Also many sperms may not be able to move actively or may be abnormal in appearance.

What is a semen analysis?

A semen analysis is a basic, informative test which helps us to tell you how many sperms you have, how many of them are moving and how many of them are normal in appearance. It is done as a routine first test for all males who present with a delay in conceiving.

When should I have the test?

A semen analysis should only be done after 2-3 days of abstinence from intercourse. A longer or shorter period of abstinence will cause misinterpretation of results.

How must semen be collected?

  • A clean, sterile, non toxic container will be provided
  • The plastic cover on the container must be removed and your name must be written on the label pasted on the container
  • Your hands must be washed only with plain water
  • The sample must be produced by masturbation
  • The sample must not be collected during intercourse as the first part of the semen which contains maximum numbers of sperms will be lost
  • Condoms must not be used during collection. They contain a substance which will kill the sperms
  • We will provide a room within the hospital to provide a sample. It is best that you collect the sample here.
  • If the sample is brought from home, it must be delivered to us within 30 minutes
  • While transporting the sample, it must be kept warm – preferably in the trouser pocket.

How is semen tested?

We first measure the quantity or volume of semen. The normal volume must be between 1.5ml – 6ml. Reduced volume may indicate fewer sperms which may reduce fertility. Too much semen may once again dilute the sperms.

We then check to see if the semen becomes liquefied. Normally semen becomes a thick gel soon after ejaculation and then becomes a thinner fluid in 30 min. Very thick semen which does not become thin may interfere with sperm movement

pH – this is next tested. Semen must have a pH of between 7.2 – 7.8. A higher pH may indicate infection while a lower pH may indicate that certain important gland secretions are absent

Fructose is a sugar which is normally present in semen. Absence of fructose may indicate that certain glandular secretions are absent. We then check a drop of semen under a microscope after mixing the sample well. We assess the :-

Numbers (sperm concentration) – This is measured in millions per millilitre. Normally there should be at least 15 million sperms/ ml or totally 39 million sperms in a complete sample. Lower numbers of sperms can reduce fertility

Movement (sperm motility) – This is the number of moving sperms in a sample. At least 32% of sperms must move forward in a straight line at good speed. Sperm movement is graded from 0-4 with 0 being non motile to 4 being rapid progressive ovement. At least 40% of sperms must be motile.

Appearance(Morphology) – The appearance of the head, mid piece and tail are studied. Abnormal sperms may have defects in the head, tails etc. At least 4% of sperms must be normal. Greater number of abnormal sperms will reduce fertility

Vitality( live or dead)- This is tested by staining the sperms with a special dye. At least 58% of sperms must be alive.

White blood cells– a count of above 1 million white blood cells per ml may indicate the presence of infection.

Certain terms used in your report

Aspermia – absence of semen

Azoospermia – absence of sperms

Oligozoospermia- Low sperm count

Asthenozoospermia- Low sperm motility

Teratozoospermia- greater number sperms with abnormal appearance

Is there anything else you need to know?

We can tell you whether your semen analysis is satisfactory based on the test report. However, this test does not give us information about sperm function. Absence of sperm needs to be confirmed by repeat testing. Abnormally low numbers/motility/morphology will also need repeating.

The test report will be discussed further in detail by your doctor. If you have any queries please do not hesitate to ask us – Jananam team

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