A semen analysis is a laboratory test that evaluates sperm count, vitality, motility and morphology of spermatozoa (how well they move and how well they are shaped) along with few other things.
Semen is the thick fluid that comes from man’s penis when they ejaculate during sexual activity. It carries sperm out of the testes, so that the sperms can fertilize an egg and create an embryo inside a woman’s womb (uterus).
- As a part of Infertility check up for a man, when a couple is having difficulty in getting pregnant
- To check for success of vasectomy – a semen analysis is done 8 to 16 weeks post vasectomy to check if the procedure was a success or not.
For performing a semen analysis, your doctor or lab will ask you to follow some instructions, which may be as mentioned below:
- To avoid or abstain from sexual activity/masturbation for 2-7 days (abstinence period), in order to get a sperm count, as high as possible. Anything lesser or greater than this can affect your report.
- To avoid Alcohol, few drugs like Testosterone supplements, Anabolic steroids, Opioids, Drugs of abuse like Marijuana etc, as these can falsely lower the quality of sperms produced. One should inform the doctor if he is on any herbal medications/supplements.
- You will be asked to collect the semen sample by masturbation into a sterile container, either in a private room in the clinic/lab, or, at home if it is convenient. If the sample is collected at home, then one must ensure that the sample is transported at body temperature (by keeping close to the body) and within 1 hour of collection.
- It is advisable to urinate and clean the genital area before collection of semen sample.
- The entire ejaculate must be collected for analysis, into the container. Collection in condoms may not be acceptable in all labs, kindly ensure beforehand with the lab/clinic.
Once the lab gets the semen sample for evaluation, the lab checks for pre-analytical issues and quality checks. If the sample is acceptable, then it is evaluated for few chemical and physical tests. It is also examined under the microscope for sperm quantity and morphology.
Some of the tests are described below:
- Sperm count – normal sperm counts are greater than 15million/ml in a semen sample. Anything lesser than this would be termed as OLIGOSPERMIA.
- Sperm Motility – A sperm can have a progressive or non-progressive motility or it can be immotile. A sample is analysed for the percentage of motile sperms. A normal semen sample will have more than 40% (>50% in some labs) motile sperms.
- Sperm Morphology – Sperm has a head, mid-portion, and tail. Any kind of defect in these parts will lead to difficulty in sperm penetration into the egg. So a sample is analysed for normal vs defective sperms. Sperms greater than 4% with normal morphology is adequate in a normal sample.
- Sperm vitality – Sperms are analysed for their viability (alive or dead).
- Other information namely Volume, Viscosity, pH, Colour, Liquefaction time, Fructose, Number of epithelial cells, pus cells and RBCs in the sample are also checked for and provided in the report.
The exact estimate of the counts cannot be made in one single sample analysis but requires to be done 2-3 times in a period of over 1-2 months. An average of these results will be better for diagnosis. Hence a repeat sample testing after an abstinence period of 2-7 days in between samples is advised. Additional specialized tests like Sperm antibodies, Sperm penetration assay (SPA), sperm’s ability to fuse with egg, cervical mucus penetration test etc are required in some cases.
Some of the common terminologies used in interpretation:
- Oligozoospermia – Low sperm count
- Asthenozoospermia – Reduced motility
- Teratozoospermia – Abnormal shaped sperms
- Azoospermia – absence of sperms in semen
- Aspermia – absence of semen
- Hypospermia – low semen volume
- Hyperspermia – high semen volume
- Pyospermia – high in pus cells
- Hematospermia – blood/RBCs in semen
- Necrozoospermia – high in dead sperms