Semen/Sperm Analysis

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Semen is the fluid released when a man ejaculates. A semen analysis provides male fertility testing. It's a test that gives more detail on the overall health of a man's sperm, which is part of the semen. It is sometimes called a sperm count test but the test actually analyzes more than sperm count.

Doctors may recommend a semen analysis if a man and his female partner trying for a pregnancy are having a difficult time. The analysis can help determine whether the problems may relate to fertility issues in the man. It may also be done to determine whether a male vasectomy was effective. A vasectomy is a surgical procedure to prevent sperm from getting into the semen.

A semen analysis assesses various aspects of the semen, sperm and male fertility. It measures:

• how much semen is ejaculated
• how many sperm are in one milliliter of semen
• the sperm's shape, including the portion of abnormally shaped sperm
• how well the sperm moves

Doctors suggest that you avoid any ejaculation in the 24 to 72 hours before the test. But some experts also suggest that test be taken no more than seven days after a previous ejaculation.

Men should also avoid exposure to excessive heat in the two to three months before a test. Examples include: frequent use of hot tubs, or workplace exposure to high heat.

Yes. A number of chemicals and drugs can affect the test results. You'll want to discuss with your doctor whether you should stop taking some medications. Things that can affect the test results if taken in the days before the test include:

• alcohol
• caffeine
• recreational drugs like cocaine and marijuana
• most herbal supplements
• some antibiotics
• testosterone supplements
• chemotherapy drugs
• certain medicines for high blood pressure
• some medicines for heartburn
• drugs used to treat an enlarged prostate

The preferred method to collect the semen sample is in a private room at fertility clinic or other medical facility. The man will be asked to ejaculate into a sterile container.

A technician then analyzes the semen under a microscope to learn more about its contents.

Other methods to collect the sample can be used -- including sex with a special condom that doesn't have chemicals that can affect the sperm, sex with withdrawal before ejaculation, and ejaculation that can be stimulated through electricity. But a semen sample should be assessed within about an hour of ejaculation, so most providers prefer in-clinic collection.

Many men feel uneasy about in-clinic semen collection. Your doctor can offer suggestions that may help.

Most experts recommend that at least two samples be taken, at least a week apart. That's because a man's sperm counts can vary day by day.

Your doctor will analyze several characteristics of the semen and sperm, to determine whether those characteristics are in a normal range. Results assessed will include:

• Volume: how much semen is ejaculated. Normal is 1.5 to 6 milliliters, which is about one-third of a teaspoon to a teaspoon.
• Sperm count or number of sperm: Normal is considered at least 20 million sperm per milliliter of ejaculate.
• Sperm shape: It's considered a normal result when more than half of the sperm are shaped normally, in terms of the sperm's head, midsection and tail.
• Sperm movement: It's considered a normal result if at least 40 percent of the sperm are moving an hour after the man has ejaculated. Sperm movement is important in male fertility because sperm must reach the egg to fertilize it.
• pH level: The pH level should be at least 7.2. Below that and the semen may be too acidic and kill the sperm.
• Liquefaction: Experts recommend it should be 15 to 30 minutes before semen liquefies. The semen is at first a thicker fluid. It should turn more watery over time to help sperm move.
• Viability of sperm: This refers to what portion of the sperm are alive in the sample of semen. Experts recommend that at least 58 percent of the sperm should be viable, or alive.

Results that are outside normal ranges could suggest a range of issues. They could mean male infertility, because not enough sperm are reaching and penetrating eggs to allow for a normal chance at conception.

Abnormal results also could suggest other health problems.

If your results are outside normal ranges, your doctor may suggest additional tests.

There are fertility treatment options if your results are abnormal. They include:

• Change in lifestyle: poor eating, exercise and other bad habits can lead to low sperm counts
• Treat underlying medical issues: Diabetes, celiac disease and a thyroid imbalance can contribute to male fertility issues
• Hormone treatments: In some cases, hormone treatments can raise sperm count
• Surgery: In some cases, what's called a varicocele -- an enlarged vein in a man's scrotum, similar to a varicose vein -- can cause low sperm counts. Surgery can fix that.
• IVF: With In-Vitro Fertilization -- or IVF -- medical experts combine sperm and egg manually, in a laboratory dish. It can allow for conception even for men with very low sperm counts.

You can find home tests that analyze sperm. But they generally test only for sperm count.

So obtaining a normal result in sperm count doesn't mean there might not be other issues with the man's semen or sperm.

Sources:
https://www.healthline.com/health/semen-analysis#outlook
https://americanpregnancy.org/infertility/male-fertility-testing/
https://www.verywellfamily.com/understanding-semen-analysis-results-1960155