Semen Analysis

What is semen analysis? 

Semen analysis is one of the most important components of a male fertility assessment. An array of factors like sperm count, morphology and motility are assessed to identify if a male is fertile or not. While some men may have inhibitions about getting tested, there is no need to be embarrassed. Male infertility is a more common problem than one would assume with around 1 in 10 men being afflicted in some shape or form. 

When is a semen analysis recommended?

A semen analysis is indicated when a couple is having trouble getting pregnant. Semen analysis forms the first line of investigation in such cases and other follow-up tests may be performed to confirm the same.

Yet another important indication of a semen analysis is in cases of vasectomy to verify the effectiveness of the procedure. It is a form of contraceptive procedure in males where the vas deferens are severed and tried around in a loop, hence preventing the transport of sperm cells into the ejaculatory duct. This leads to the absence of sperm in the ejaculate which is later confirmed using a semen analysis. 

How is semen analysis performed? 

Sample for semen analysis is collected by a variety of methods. These include: 

  • Masturbation- the safest and the most commonly used practice in collecting a sample 
  • Sexual intercourse with a specialised condom- use of lubricant or a spermicide must be avoided since it may adversely affect the test results
  • Withdrawal before ejaculation- sample will need to be transported within an hour of collection and must be stored at room temperature during transit.

What are the factors that are assessed?

A number of factors will have to be checked in order to ascertain if the obtained sample is normal or not and if a patient is fertile or not. These include: 

  1. Sperm count 

Sperm count plays a crucial role in determining a patient's fertility. Counts of 20 million to 200 million sperm cells per millilitre of the sample are deemed to be normal. Anything lesser than 20 million may impact fertility and this condition is termed oligospermia.

  1. Sperm volume 

The optimum sperm volume is reported to be 2 millilitres. Lesser volume may imply less number of sperm cells, which has a direct correlation with a person's ability to beget children. On the other hand, an excess volume of semen may imply that the total concentration of sperm is diluted.

  1. Sperm motility 

Sperm cells, after being deposited in the female reproductive tract, will need to travel all the way to the fallopian tube, where fertilization with the female egg occurs. Hence, sperm motility is considered to be an important determinant that will have to be accessed in semen analysis. More than 50% of sperm cells will have to display normal motility, the absence of which is clinically described as asthenospermia

  1. Sperm pH 

The prescribed normal range is 7.2 to 7.8. pH less than 7.0 could indicate that the sample may have been contaminated, whereas a pH more than 8.0 could indicate an underlying infection. 

  1. Appearance 

Semen normally appears to be whitish-grey or opalescent. A reddish-brown hue might be characteristic of blood, while a yellow tint might be indicative of jaundice. 

  1. Liquefaction 

It should ideally only take 15 to 30 minutes for a sample of semen to liquefy completely. Liquefaction is said to help the sperm move within the confines of the female reproductive tract. So, liquefaction time in excess of 30 minutes might adversely affect fertility.

1. How does a patient prepare for semen analysis?

While it's always recommended to talk to a health professional, here are a couple of general instructions to remember. • Abstain from having sex for 1 to 3 days prior to the test • Refrain from smoking and consuming alcohol for at least 4 to 5 days before the test

2. What are some of the medications that may affect the results?

Some of the drugs that may affect the results include: • Testosterone supplements • Anabolic steroids • Opioids

3. Are there any risks associated with this test?

There are no risks or health hazards that are associated with this test and it is completely safe.

4. When can one expect the results of this test?

It may take close to a week for a laboratory to process the sample and for the reports to be made available. But, this is just an estimate, and the time duration may vary from one laboratory to another.

5. How are patients followed up in case the semen analysis points out to an abnormality?

In cases where there is a derangement in semen analysis, a health professional may recommend the following tests to identify the causative factor. • Hormonal assays to identify the levels of testosterone in the body and detect hypogonadism • Post-ejaculation urinalysis to rule out retrograde ejaculation • Sperm antibody testing to gather more information regarding a sperm cell's ability to penetrate an egg • Genetic testing to identify implicated disorders like Klinefelter's syndrome

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