Semen analysis is one of the major infertility tests carried out to figure out issues with a man’s inability to conceive. Following a year of unprotected sexual intercourse, one in six couples report being unable to conceive. Despite how solitary having a fertility problem might feel, it is rather a common issue.
As infertility affects both men and women alike it is not always a woman’s problem. About 30% of the time, the couple's failure to conceive is caused by issues with male fertility. While it might feel rather scary, the good news is many of these issues are treatable and some are even reversible. Assisted reproductive methods including sperm retrieval combined with in vitro fertilization (IVF), IntraCytoplasmic Sperm Injection (ICSI), or Intrauterine Inseminations (IUI) are available if the issue cannot be resolved.
If a couple is trying to conceive and they are unable to do so after a year of routine unprotected sex or if one spouse may have a history of decreased fertility, they should both be evaluated. At Nepal IVF a urologist with experience in male infertility will evaluate the guy, which should involve a thorough medical and reproductive history, a physical exam, and at least two semen analyses. The urologist may suggest more tests after the examination, followed by therapy, depending on the findings.
What Causes Infertility in Men?
Infertility in men is a common issue as more than 30% of infertility cases are often related to male fertility. Many external and internal factors often give rise to infertility in men.
The epididymis, which is located in the top portion of the testicles, is where sperm are produced and kept after leaving the testicles. The semen that is ejaculated during sex is what feeds the sperm that has been preserved. The entire process is dependent on men's hormones and testosterone levels. When these hormones and testosterone levels are affected (decrease or increase) via different factors it has a direct impact on a person’s fertility.
Different factors (medical and external) that have either direct or indirect effects on male fertility are:
Components of Sperm Analysis
Semen analysis is considered the most important test while diagnosing male infertility. The semen analysis test includes examining sperm volume, morphology, concentration, motility, and sperm count. The need for an immediate semen analysis would arise if the solution is irregular or low. Sperm analysis covers the following analysis:
Oligospermia:
Oligospermia or simply known as low sperm count is one of the major sperm-related infertility issues. People with oligospermia have difficulty achieving and sustaining erections and often can not ejaculate during an orgasmic event.
According to WHO, a normal sperm count would be around or more than 15 million per milliliter (mL) of semen. Anything less than that is deemed low and is given the label of oligospermia. The condition is divided into three different categories:
Mild Oligospermia (Sperm count between 10 to 15 million)
Moderate Oligospermia sperm count between 5 to 10 million)
Severe Oligospermia (sperm count below 5 million)
Motility
Sperm motility refers to the sperm's capacity for rapid movement. Sperm must travel through the female reproductive system to reach and fertilize the egg, this is significant for fertility. Male factor infertility can be brought on by poor sperm motility.
Looking for sperm motility is one of the major roles of semen analysis.
Sperm Antibodies
Looking out for sperm antibodies in the semen is also carried out while conducting sperm analysis. Sperm antibodies are antibodies that develop when the immune system is exposed to significant amounts of sperm through a breach in the blood-testes barrier, due to trauma, torsion, biopsy, or vasectomy (the latter being the most frequent cause seen). Once developed these antibodies have the potential to impact sperm motility and how well it interacts with the egg.
Morphology of Sperm
Morphology of the sperm (shape) also contributes to the performance of the sperm in a long run affecting infertility. A typical human sperm features a paddle-shaped head, a neck, a central region, and a tail. This shape enables sperm to travel swiftly and directly toward its target. Normal sperm has the following qualities in general:
The head measures 5 to 6 micrometers in length and 2.5 to 3.5 micrometers in width.
The cap covers 40% to 70% of the sperm's head.
There are no droplets of fluid larger than half the size of the head.
There are no aberrant structures in the neck, midsection, or tail.
If the shape of the sperm is not normal it will have a hard time entering an egg for fertilization. Higher the percentage of properly shaped, the higher the chance of achieving pregnancy.
Sperm Concentration:
As discussed earlier a normal concentration of sperm is considered to be around or more than 15 million per milliliter (mL) of semen. Anything below the number has a huge chance of affecting the fertility of a man.
In some cases, semen contains no sperm at all. The condition is called azoospermia. While checking for sperm concentration fertility specialists also have a go at azoospermia
Sperm DNA Fragmentation Test
Sperm DNA fragmentation occurs when one or both of the DNA strands of the chromosomes present in the sperm undergo a nucleotide mutation or a physical break. The major factor causing fragmentation in sperm is oxidative stress. Oxidative stress occurs when free radicals—atoms with an unpaired electron—damage the body over time without being sufficiently neutralized by antioxidants.
Infections, drug use, smoking, exposure to pollutants at work and in the environment, advanced age, varicocele, illnesses with high fevers, elevated testicular temperature, chronic illnesses like diabetes, cancer, and cancer treatment, a poor diet, and obesity are all linked to sperm DNA fragmentation.
High-level DNA fragmentation can be used to determine people who have frequently experienced miscarriages or failed therapies. The fertility test is helpful for people who have high leukocyte counts or who have spent more than 40 years being exposed to harmful substances or diabetes.
How To Prepare For Semen Analysis
Preparing for your semen analysis is not as scary as it seems. Before your sperm analysis test, a doctor or fertility expert will brief you on the steps and to-do list (not to do too). You are required to follow the instruction properly as it is crucial to get an accurate test result.
A person undergoing sperm analysis is requested to avoid drugs, caffeine, alcohol, and sexual interaction for 3 to 5 days prior to the test. If a patient is undergoing any chemical or hormonal treatments they may have to cease it before taking a sperm analysis test.
Proper hormonal stimulation of the pituitary glands, an unhindered sperm route, natural sperm transport, and hormone stimulation from the pituitary gland are essential for healthy sperm production and pregnancy. If any of these systems have been affected in any way, a high chance of male infertility arises.
What Happens at a Sperm Analysis Test?
(one thing is for sure, you will never look at plastic the same way again)
If it is necessary for you to have a sperm analysis test, fertility experts will request a sample of your semen. The sample semen will then be analyzed to figure out the cause of infertility.
There are a few methods of extracting semen for sperm analysis tests, like:
After you have completed the sperm extraction at home, it is very important to get the “clinical sample” to the fertility center quickly, preferred time for delivering the sample is within an hour. Another important step to remember is to keep the cup or object you have ejaculated into at body temperature (a shirt pocket is the best). This will help in maintaining the motility of the sperms.
If one follows all the instructions provided by the doctors it leaves all very little room for error. However, despite following all the procedures meticulously, sometimes a few errors can have a huge impact on the test results. Often errors made during sampling in a lab, contaminated containers, semen getting in contact with spermicide, and other factors often hamper the results.
How will Sperm Analysis turn out?
Once your samples are analyzed you will get the results and treatments (if necessary) can be carried out. If your result falls below the following parameters (or what is deemed normal) the cause for infertility can be determined. The parameters analyzed by sperm analysis:
Sperm Concentration: Normal sperm concentration is considered to be 15 million per milliliter (mL) of semen. Anything less than that may cause infertility.
Motility: The motility of the sperm is a major determinant of fertility in men. Semen which has 32% of sperms active or moving is considered normal. If your result falls below 32% it can be the cause.
Acidity Count: Semen pH is a measurement of the semen's acidity or alkalinity. The prostate fluids should be more acidic, but the seminal vesicle fluid should be more alkaline. They work together to maintain equilibrium in the semen. A normal pH (Measure of the acidity or basicity of an aqueous solution) in semen counts between 7.2 to 7.8. If the numbers go below or above the normal rate, it will be less habitable for sperm.
Sperm Morphology: A sperm is deemed normal if it has an oval-shaped head that is 5-6 micrometers long and 2.5-3.5 micrometers wide, under a microscope. Infertility rises by 2.9 times when sperm morphology is less than 9%. Only about 14% of sperm with typical-shaped heads are normal.
Fructose Level: High quantities of fructose are typical in semen, and practically all of this sugar derives from the seminal vesicles. Low semen quantities will occur from obstruction of this auxiliary gland, which can be caused by an infection or tumor, as the seminal vesicles ordinarily generate 70% of the seminal fluid.
Semen Liquefication: Semen is rather dense during ejaculation gradually liquefying, which doesn’t take longer than 20 mins. Liquefication of semen or semen liquefication is basically the time it takes for semen to liquefy. If the time taken by semen to liquefy slows down the sperm might never reach the egg.
If you are looking for a confidential as well as a trusted fertility center for sperm analysis, you don’t have to look far from Nepal IVF. Nepal IVF and its team of fertility specialists have more than 20 years of experience treating male infertility. Contact or visit Nepal IVF today for a better tomorrow.
