If you are looking to determine your chances of future fertility or have been unsuccessful in pregnancy with your partner, semen analysis may be a procedure you should consider to realize your fertility goals.
Did you know having a low or abnormal sperm count suggests male infertility, but the range can be deceiving and overlap into normal statistics? Since other sperm factors could affect your ability to fertilize an egg, semen analysis may be the only way to really get answers.
What Are Normal Sperm Counts?
You are considered to have a normal sperm count if you have 39 million in one ejaculate with a sperm concentration of 15 million/ml or higher.
A sperm volume of 1.5 ml or higher means that you are experiencing normal sperm overall volume.
Why Should I be Concerned About Sperm Motility and Shape?
Reproduction has many components. Sperm count is only one factor. For this reason, normal sperm count is not the sole predictor of a pregnancy. The ability of your sperm to move (motility) or swim is also another piece of the equation.
If you are diagnosed with poor sperm motility this is referred to as asthenozoospermia.
Normal sperm motility should be above 40% or greater and progressive motility greater than 32%. They should not clump or stick together (agglutination), which can make it difficult for them to travel or move normally. This impairs motility.
The shape (morphology) and movement (motility) of your sperm can also indicate your production of normal sperm that is ready to fertilize an egg.
A strict morphology (sperm shape) of 4% or higher is normal.
Semen analysis investigates not only your sperm count but also the quality and shape of your sperm to determine which factors may be affecting your ability to complete your future family and achieve your goals of biological children.
What Is the Semen Analysis Process?
You will first undergo a general exam with questions concerning your family history and past and current health problems, surgeries, illnesses or injuries that could affect your genitals and ability to partner pregnancy. It will also include a physical exam with questions concerning your sexual development.
Semen samples will be required to determine sperm count and can be provided through either:
- Collection in a specimen container in the office or at home
- Specialized condom used to collect sample during intercourse
If you are unable to provide a sample, other sperm retrieval procedures may be used to collect your semen.
Accuracy of the semen sample is important. For best results you will be asked to take the following steps during the process:
- Abstain from ejaculation at least 2 days prior to testing but no longer than 11 (ideally 2-5 days)
- Attempt to collect all semen in the specimen container
- Collect an additional sample 2 weeks after the first
- Avoid all use of lubricants
Once the semen sample is available, it will be examined microscopically to determine the number of visible sperm within a given area and compared to normal statistics.
Because variability with semen samples can occur, it is not unusual for you to be asked to undergo several collections over time.
Testing for Low Sperm Count Causes
If you are diagnosed with low sperm count your doctor may recommend one of the following additional tests to determine reasons why the count is poor.
- Hormone testing
- Urinalysis after ejaculation
- Ultrasound of testicles or prostate
- Genetic tests
- Sperm function tests
- Testicular biopsy
- Antibody testing
What Are Low Sperm Count Treatments?
Being diagnosed with low sperm count is not an end to your pregnancy dream. There are treatments available, including:
Blockage repair
If testing shows that you have normal sperm count within your testicles but no emission, a blockage may be likely. Blockages may occur over time and can be due to a common condition found in low sperm count called varicoceles. This is an enlargement of the veins within the loose bag of skin holding your testicles (scrotum) similar to varicose veins. Some varicoceles do not cause symptoms, but if the condition is hindering your sperm, it can be easily repaired surgically.
In the case of an obstructed vas deferens, the duct that leads from the epididymis to your ejaculatory ducts, transporting your semen prior to ejaculation may be blocked or non-functional. Surgical repair can also be performed.
Men who have undergone vasectomies have this duct intentionally blocked during a surgical procedure known a vasectomy. Often a vasectomy reversal can be performed to allow normal flow of semen and sperm to achieve pregnancy with your partner, but there is no guarantee the sperm count or function will be normal after vasectomy reversal.
High or low hormone level correction
If testing proves you may have a hormone imbalance in your FSH, TSH, T4, Prolactin or testosterone, your doctor may recommend hormone medications to treat the medical condition or increase your sperm count, and possibly additional testing.
Medication treatment for retro-grade ejaculation
Sperm in urine may be evident in the post-ejaculation urinalysis while testing for low sperm count causes. If present, then this means your sperm is being directed backward into your bladder and not into your penis during ejaculation. This is called retro-grade ejaculation. At this point your doctor will look for possible medications that you are currently taking that might be causing the problem or test you for diabetes, which is another condition where this symptom could arise. This condition can be treated with medication as well.
Assisted reproductive technology treatment
Assisted reproductive technology (ART) can be used in many situations both in normal ejaculation as well as dysfunctional cases. In these treatments, the sperm is collected through normal ejaculation, surgical extraction or from donors. Once this process is completed, your sperm can be used for IVF with Intracyotoplasmic Sperm Injection (ICSI).
Antibiotic therapy for urinary or reproductive tract infections
If reproductive tract infections are found, your doctor can prescribe antibiotic medications for treatment. These may or may not correct your low sperm count.
Genetic testing
Chromosome (karyotype) and Y chromosome deletion testing should be done for total sperm concentration less than 5 Million/mL. Results can determine if the condition is treatable and also provide fertility options or alternatives moving forward.
If you and your partner have been trying to get pregnant for over 6 months, Inovi has highly trained specialists and advanced methods to detect and correct issues that may involve the male reproductive system.
Call our offices at 713-401-9000 or schedule your private consultation to get on your path to pregnancy.