Key points about semen analysis

• A semen analysis is a laboratory test Ember Fertility performs to evaluate the quantity and quality of a man’s sperm and semen, which is the thick white fluid released from the penis at ejaculation that contains sperm.
• Males are a sole or contributing factor in about 40% of all infertility cases, and the most common male cause is due to sperm problems.
• Semen analysis is the preeminent male infertility test, revealing information on sperm count, sperm motility (movement), morphology (shape) and other factors affecting male fertility.
• Results of a semen analysis give our fertility specialists vital information on the best treatment plan for the couple or individual to achieve pregnancy.
• Ember performs semen analysis in house, reducing costs, and our lab also facilitates sperm DNA fragmentation analysis.

What is semen analysis?

A semen analysis is a laboratory test that evaluates a man’s semen sample for a variety of factors related to sperm and semen health that affect fertility. This is one of the first tests in evaluating a couple’s problems conceiving, as the man is a contributing factor or the sole factor in up to 40% of infertility cases, according to The Society of Reproductive Surgeons.

RESOLVE, the National Infertility Association, notes that male sperm issues account for about 20% of all infertility cases.

Ember is unique in being a fertility clinic that performs its own semen analyses rather than referring our patients to other lab services. And many outside lab services providers do not conduct semen analyses. We’re glad to offer our patients this convenience.

Candidates for a semen analysis (also called sperm test or semen test)

When a couple or individual is having trouble conceiving, the best course of action is to test both partners. The semen analysis is the prominent infertility test for males, conducted in conjunction with a physical exam and discussion of sexual and medical history.

This male infertility test is particularly important if testing of the female partner shows no cause for infertility. Information gathered in an initial discussion with the male patient can also indicate sperm quality may be the cause for problems.

Men who have had a vasectomy for sterilization also need a semen analysis to make certain sperm is not in the semen. A sperm analysis can also determine if a man recovering from medical treatments, such as fertility-harming cancer treatment, is fertile.

Sperm DNA fragmentation test

Some male patients may need a further test beyond semen analysis to assess the health of their sperm. A DNA fragmentation test checks for single-stranded or double-stranded breaks in the genomics of sperm cells. The body cannot repair these breaks, which may reduce a man’s chances of fathering a child.

Ember’s IVF lab works with other specialized labs to facilitate DNA fragmentation tests for some patients. This test is not part of a normal semen analysis.

Semen analysis results

This test for male infertility evaluates sperm, which are the reproductive cells that carry DNA material and fertilize an egg for pregnancy and a child. The analysis also reveals many aspects of semen, the whitish-gray fluid released by the man during ejaculation.

Semen includes lubricating fluids that enable the sperm to travel to the back of the vagina and proteins and minerals that nurture sperm health. Following are results we derive from a semen analysis.

Sperm count and sperm concentration

These terms are similar but different and both affect fertility. Sperm count is the number of sperm in the semen ejaculated. A low sperm count is less than 39 million sperm in the semen. Sperm concentration refers to the number of sperm in a milliliter (mL) of semen, with 15 million per mL considered to be normal.

Sperm motility

Sperm motility evaluates the percentage of sperm that move and how well they move. Sperm has to move from the vagina to the egg in the fallopian tube for fertilization. The sperm looks like a tadpole, and the sperm’s tail is a major factor in sperm motility.

Sperm morphology

Morphology refers to the size and shape of the sperm. The parts of sperm are the head, midpiece and the tail. Sperm morphology evaluates the count of DNA genetic material in the head and the head’s shape, which is important in penetrating the egg.

Semen volume

This is the amount of semen in the ejaculation. Normal semen volume is 2-5 mL, or a half to a whole teaspoon. Less than 1.5 mL of semen is considered to be hypospermia, which can be a factor in fertility.

Semen liquefaction time

This is the time it takes for semen to change from a sticky substance to a fluid liquid. Longer time for liquefaction can harm sperm motility and fertility.

Semen pH scale

The pH scale of semen is the balance of acids and bases in the sample. If the pH is too low it can indicate a blockage, if it’s too high that can indicate infection. Improper pH scale can cause problems with sperm health.

Semen white blood cell count

High white blood cell count in semen can indicate infection or inflammation. Both can affect sperm quality and quantity.

What the male needs to do for a semen analysis

Essentially all the male has to do is to provide a sample of semen to our IVF lab. We will provide instructions and a sterile container to collect the semen sample. Men can provide the sample through masturbation at our clinic or at home.

Men submitting semen samples should adhere to the following.

• Avoid ejaculation for 2 to 7 days prior to providing the sample. This allows for adequate sperm count (abstaining for more than 7 days can have negative results).
• Masturbate to ejaculate. Collect the semen, which should be the entire ejaculate expelled with sexual climax, in the sterile container.
• Special condoms are also available to ejaculate in during intercourse and then transfer to the container. Do not allow the semen to come in contact with saliva or vaginal or manufactured lubricants, all of which can damage the sample.
• Keep the semen at body temperature and deliver it to our clinic within an hour. If this time frame isn’t possible, the man will need to provide the sample at our clinic.

TESE (testicular sperm extraction)

Men with low sperm counts or poor sperm motility may need a testicular sperm extraction (TESE). This is a surgical procedure that takes sperm directly from the man’s testicle, to collect sperm for his semen analysis or for the resulting fertility treatment, such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), etc.

Ember Fertility is proud to partner with a local urologist, conveniently located on the same medical campus, to provide TESE for our patients.

How a sperm analysis guides fertility treatments

A semen analysis can help our doctor determine appropriate steps for a couple or individual. Aside from findings indicating no action is needed, treatments can include:

• Lifestyle changes such as managing weight, quitting smoking and reducing alcohol intake. These steps can enhance sperm quality.
• Medical treatments to address infections or underlying health conditions.
• Fertility treatments
  • Medications to achieve proper reproductive hormone levels.
  • Surgery to correct blockages preventing sperm delivery
  • Treatments such as intrauterine insemination (IUI) or IVF with ICSI.