How Do I Interpret Basic Semen Analysis?
Have you been trying to conceive for some time? We live in an information-driven age and most couples prefer to make informed decisions. Whether it is about thinking of getting pregnant or considering delaying pregnancy for some time. In both situations, a fertility MOT can give you peace of mind. For some it will provide information that may be useful in deciding the timing of starting a family or to seek help.
Semen analysis is one of the initial male fertility tests done as part of a fertility MOT or for investigating couples facing difficulties conceiving. One in five couples seeking fertility treatment may be facing difficulties in conceiving mainly due to male infertility. It also plays a part alongside other causes of infertility in another third of the couples seeking fertility treatment at London IVF clinic.
The male fertility MOT at our London IVF clinic includes a clinical assessment with our fertility expert, including semen analysis. As one of the best IVF clinics in London, we believe in providing detailed and comprehensive information that helps our patients to make informed choices. The detailed semen analysis looks at a range of parameters such as sperm count, sperm concentration, sperm motility, sperm morphology, presence of anti-sperm antibody or inflammatory cells, acidity of seminal fluid and volume of the seminal fluid, to name a few. When normal, it gives our patients reassurance about their fertility. For others who have an abnormal semen analysis, consultation with a fertility expert at our London fertility clinic will give better understanding of their situation and the next step.
Instructions before producing a sample for semen analysis
Sperm production is a delicate process. It is easily influenced by a range of factors. In order to get a valid result, it is important that you follow the instructions. Before providing a semen sample, you should have abstained from sex for at least two days and no more than five days. You can produce the sample at the London IVF clinic andrology laboratory. When producing the sample at home, you should use a specimen bottle provided by our fertility clinic in London. Any other container may have some materials or chemicals that are toxic to sperm. This will affect your test result and may show up as an abnormal result. When producing a sperm sample at home, the sample should be presented to the Andrology laboratory within an hour.
Semen fluid volume
The seminal fluid volume indicates the function of the male reproductive tract from testes to the male accessory glands and tract. A typical semen fluid volume is usually between 1.5 and 4ml. A low volume of less than 1.5ml is called oligspermia or hypospermia. It may suggest an incomplete collection. The other reasons for oligospermia may be obstruction, retrograde ejaculation or problems with the male reproductive accessory glands that line the ducts.
What is low sperm count or oligozoospermia?
A normal sperm count or concentration is over 20 million sperm/ml. Low sperm count is also called oligozoospermia. Mild oligozoosprmia can be affected by lifestyle factors or minor illnesses. Most low sperm counts (oligozoospermia) go unexplained. However, sometimes this could mean there is a fertility problem that needs further testing. Therefore, a fertility specialist at our London IVF clinic may suggest repeating the test in two to three months. Very rarely, a few men may have very low sperm counts of less than five million per ml. This is known as severe oligozoospermia. There are many causes such as medical illnesses, infections, blockages, testicular failure or genetic causes such as Klinefelter syndrome that may result in very low sperm count. It may be helpful to seek help and further advice not only about your fertility, but also whether it may affect your general health in the long term.
What is low sperm motility or asthenozoozpsermia?
Asthenozoospermia or low sperm motility can cause male infertility by affecting the sperm function. In any sample, we expect about 50% of the sperm to be swimming and at least 32% should have a forward movement pattern. Progressive sperm motility is important for the sperms to be able to make their way into the female tract to fertilise the egg. If you have abstained from sex for long periods of time, sperm may begin to die and the motility will be affected. There are also other causes of low motility.
What is abnormal sperm morphology or teratozoopsermia?
Teratozoospermia or low normal sperm morphology refers to the shape of the sperm. According to World Health Organisation guidelines, normal sperm morphology of less than 4 per cent is abnormal. If that is the case, your specialist may suggest fertility treatments such as Intracytoplasmic sperm insemination or ICSI.
High white cell count in semen or Leucospermia
The presence of significantly high white blood cells indicates the presence of infection. More than one million white cells per ml generally suggests an acute or a silent infection. Sometmes immatire sperms may look like white cells. Hence, at London IVF Clinic we use special stains to differentiate these white cells from the immature sperms. Leucospermia can be easily treated with the right antibiotics. Such simple treatment will clear the infection and may improve your chances of conceiving either naturally or following treatment.
Sperm Agglutination (‘Sticky Sperm’) Mixed agglutination reaction or MAR test
In normal circumstances, the sperms are protected by the blood testicular barrier. However, if this barrier is breached, the body reacts by forming anti-sperm antibodies. The anti-sperm antibodies bind together the sperm cells and affect sperm function such as sperm motility or fertilisation capacity and lead to male infertility. This is a highly specialised test to check for sperm agglutination or ‘sperm stickiness’. The MAR value of over 50% is abnormal. It is not uncommon to see anti-sperm antibodies after vasectomy reversal, inflammation or groin surgery that may have affected the blood testicular barrier.
To find out more about MOT tests at our London fertility clinic, click here.