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Semen Analysis and FertilAid for Men
Fertility experts estimate that male factor infertility is to blame in up to 50% of couples experiencing fertility issues. As a result, many couples find it extremely helpful for the male partner to undergo a comprehensive semen analysis at the earliest sign of trying to conceive difficulties. Compared to many of the female fertility tests and exams, semen analysis is non-invasive, relatively inexpensive, and produces results quickly, making it a valuable tool for couples as they begin their TTC journey.
Most fertility clinics perform semen analyses. A semen analysis measures both the amount and quality of semen and the amount and quality of sperm. Semen is the fluid that a man ejaculates during an orgasm. The sperm within the semen are the cells that actually fertilize the egg. In preparation for a semen analysis, a man is required to abstain from any sexual activity for 2-4 days before the analysis. At the appointment, he is asked to masturbate into a clean, wide mouthed bottle. This bottle is then delivered to the laboratory for testing. Almost all laboratories performing semen analyses will evaluate the following semen and sperm health parameters:
- Sperm Concentration (or "sperm count"):
Sperm count is determined by looking at the semen sample under a microscope, and is a measurement of how many million sperm there are in each milliliter of fluid. The accepted standard for a "normal" sperm count is 20 million sperm per milliliter of semen. A sperm count below 20 million sperm per milliliter of semen is considered a "low" sperm count, a medical condition referred to as oligospermia. A sperm count less than 5 million sperm per milliliter of semen is referred to as severe oligospermia. When no sperm are present in a given semen sample, this is called azoospermia.
- Sperm Motility
Sperm motility is defined as the forward, swimming motion of sperm. In order for a sperm to fertilize the egg, it must travel quickly through the female reproductive system, which requires strong swimming action. The World Health Organization defines normal sperm motility as 50% of observed sperm, or at least 8 million sperm per milliliter of semen, showing good forward movement. Motility is also graded from A to D;
- A – sperm swim forward fast in a straight line
- B – sperm swim forward, but in a curved or crooked line, or slowly
- C – sperm move their tails, but do not move forward
- D – sperm do not move at all
- Grade C and D are of concern when testing for fertility.
- Sperm Morphology:
Sperm morphology refers to the size and shape of the sperm cells. Abnormal sperm may be unable to move normally or to penetrate an egg. As a result, too many sperm of abnormal size and shape can pose a significant fertility issue. Most laboratories will evaluate the sperm based on criteria provided by the World Health Organization. To determine if the sperm have normal morphology, the sperm are examined under a microscope. For a sample to be considered normal, at least 30% of the sperm must have an oval head, with a connecting mid-piece and a long straight tail.
Some laboratories use a more "strict" definition to determine if sperm are of normal size and shape. These "strict" criteria, also called the "Kruger" criteria after the scientist who originally outlined them, very specifically define what normal sperm cells should look like. According to the Kruger criteria, a normal sperm must have an oval shape with a smooth contour. The head of the sperm must be 5-6 µm in length and 2.5-3.5 µm in width, with a width/length ratio of 1/2 to 3/5. The acrosome (a cap-like structure on the head of the sperm) must be well-defined, comprising 40-70% of the distal part of the head. To be considered normal, the sperm must not have any abnormalities of the neck, mid-piece or tail and no cytoplasmic droplets of more than half of the size of the sperm head are accepted. In using these criteria, technicians will consider any "borderline" forms to be abnormal. If 14% or more of the sperm in a given sample meet the definition of normal using these strict criteria, a man will be said to have normal morphology.
- Semen Volume:
Semen volume measures the total quantity of fluid that is ejaculated. A normal amount is 2 milliliters or greater. The presence of hormonal abnormalities or ductal blockages may result in low semen volume.
- Total Motile Count:
The total motile count refers to the number of moving sperm in the entire ejaculate. It is calculated by multiplying the volume (cc) by the concentration (million sperm/cc) by the motility (% moving). There should be more than 40 million motile sperm in the ejaculate.
- Standard Semen Fluid Tests:
An evaluation of the color and viscosity (how thick the semen is) of the seminal fluid, and the time until the semen sample liquefies are often included in a comprehensive semen analysis.It is normal for the semen to liquefy in about 30 minutes. If the semen is very thick or clumps (call agglutination), motility will be impacted, making it difficult for the sperm to swim through the woman’s reproductive tract. If the sample does not liquefy within about 30 minutes, it may indicate the presence of an infection of the seminal vesicles and/or prostate.
- Semen pH:
Typically, semen is a very alkaline substance, with a normal pH of 7.2-8.0. An abnormally high or low semen pH can cause sperm death, and impact the ability of the sperm to swim quickly and or effectively penetrate the egg.
- Presence of fructose:
Fructose is a type of sugar that provides energy for sperm cells. The absence of fructose in seminal fluid can impair sperm motility, and may indicate the presence of a blockage in the male reproductive tract.
- White blood cells:
While it is normal for semen to contain some white blood cells, a large number of white blood cells in a semen sample may indicate the presence of an infection, which can decrease sperm count and motility.
A term that comes up frequently in association with semen analysis is "sperm washing". Sperm washing is a procedure that is performed on a semen sample to improve the chance of successful intrauterine insemination (IUI). In essence, sperm washing concentrates the number of high quality sperm in a semen sample by removing any dead sperm, sperm with poor motility, and/or sperm with abnormal morphology. It also separates out any white blood cells, prostaglandins (chemicals found in semen that can cause uterine contractions), and seminal fluid that might interfere with ability of the sperm to fertilize the egg. Once a semen sample is "washed" to isolate only the healthiest sperm, the sample can be inserted into the uterus.
Sperm washing increases the chance that intrauterine insemination will be successful. However, it is important to remember that IUI success rates also depend on the pre-wash sperm count. Sperm counts between 20 and 30 million/ml of semen are ideal for sperm washing and subsequent IUI, while success rates are lower if the prewash sperm count is less than 10 million/ml of semen.
If the results of a semen analysis show any abnormal sperm health parameters, treatment to improve sperm health should be started immediately and continued for a minimum of 3 months before another semen analysis is performed, as it takes the testes approximately 3 months to produce new sperm.
FertilAid for Men has been clinically proven to improve sperm count and motility. Here is what some of our customers have told us about the results of semen analyses before and after using FertilAid for Men. To read additional FertilAid reviews, click here.