Male infertility is a contributor to approximately half of all fertility issues. So, investigations into male infertility are of key importance if a couple are experiencing a delay in falling pregnant.
A man might be completely healthy but a sperm test may indicate that he produces few or poor quality sperm. Sometimes a sperm test uncovers that there are no sperm present at all. This could indicate a blockage in the vas deferens (tubes that transport sperm from the testes) or that sperm are not being produced. A physical examination and hormone assessment may be able to confirm the cause.
A semen analysis is the most important test used in the diagnosis of male infertility. A semen analysis checks the volume, consistency and appearance of the whole sample prior to assessing the sperm themselves. The number of sperm (count), the speed and proportion of swimming sperm (motility), sperm size and shape (morphology), and presence of sperm antibodies are all factors that have an impact on fertility.
What is measured in a semen analysis?
In a semen analysis, the semen sample is assessed for:
- Volume (the amount of semen produced)
- Viscosity (the consistency of the fluid)
- Count (the number of sperm)
- Motility (the speed and proportion of moving sperm)
- Morphology (sperm size and shape), and
- Sperm antibodies (presence of antibodies may reduce the ability of the sperm to swim).
If abnormalities are found, the test may need to be repeated to establish the type, degree and persistence of any problem. A semen analysis can vary depending on what has been happening in your life prior to the sample being produced. Illness, stress, fever or strenuous exercise can affect the semen analysis result.
Interpretation of your semen analysis
The primary test for male fertility is a semen analysis. If you or your partner has had a semen analysis, your GP and fertility specialist should have explained the result. However, the following guide to interpretation of your semen analysis may be useful to refer back to. Assessment should always be made in consideration with your fertility history.
- Semen Volume: The “normal range” for this is wide, anything more than 1.5ml is considered normal. It’s important that you let the laboratory know if the entire specimen was not collected as this may significantly affect the interpretation of the results.
- Concentration: This should be more than 15 million sperm per ml. Semen analyses can vary significantly and many men with a completely normal semen profile will occasionally have a low count. Accurately recording the duration of abstinence before the collection is important.
- Motility: A normal result for motility is greater than 40%. Ideally the specimen has been collected at the laboratory as a common cause for low motility is that the sample becomes cold (or warm) before it reaches the laboratory. If this is not the case and the result shows low motility a repeat specimen, collected at the laboratory is advised. If this is not possible please contact the laboratory to determine the best way to transport the specimen to the laboratory.
- Morphology: A normal result for morphology is greater than 4%. This test refers to the shape of the sperm. It does not mean that the sperm are genetically abnormal but may have an effect on the ability of the sperm to fertilise the oocyte (egg). It should be viewed in conjunction with the TZI which reflects the degree of abnormality in the shape of the sperm.
- Sperm Antibodies: This assesses for the presence of anti-sperm antibodies. Occasionally the immune system may make antibodies to sperm, which can impair sperm motility. On other occasions the presence of antibodies may impair the ability of sperm to attach to the egg and begin the fertilisation process.
How do you treat male infertility?
Intracytoplasmic sperm injection (ICSI) is a form of IVF that is particularly useful if you have a low sperm count or if there are many abnormally shaped sperm.
Surgical sperm retrieval
If the vas deferens is blocked (eg. vasectomy) or absent (eg. congenital absence of the vas deferens), sperm can be retrieved surgically from the testes for use in ICSI.
How do I organise a semen analysis?
A semen analysis is a simple test that is best performed by our specialist laboratory at TasIVF. The first step is to obtain a referral from your GP or specialist and then phone TasIVF for an appointment:
Hobart Laboratory: (03) 6212 7735
You will be asked to produce a semen sample by masturbation after 2 to 7 days of no ejaculation. The sample can be produced at home or in a discreet room at TasIVF. In some cases it is best that the sample is collected at the clinic. When you ring for your appointment the laboratory can advise you.
Further instructions for sample collection will be given when phoning TasIVF for an appointment. TasIVF currently provides semen analysis services in Hobart.