Semen analysis is a test performed to analyze the sperm count, motility, and shape of the male sperm and to test for male factor infertility. It helps in checking the sperm quality and volume in a male patient. The test involves the collection of a semen sample and its evaluation in the laboratory.
Semen is the whitish-grayish fluid released from the male penis usually after an orgasm. The semen consists of sperm, fluids, proteins, minerals, and vitamins.
In this article, we will discuss in detail the semen analysis report.
Why is a Semen Analysis Performed?
The doctor will usually recommend undergoing a semen analysis in the following two cases:
- Assessment of male infertility: A semen analysis is recommended when couples are having problems conceiving naturally. The test helps the doctor in determining if a man is infertile. Semen analysis also helps in determining if sperm dysfunction or low sperm count is the cause of male infertility.
- Vasectomy follow-up: Men who have undergone a vasectomy, a procedure in which the tubes that are responsible for sending the sperm from the testicles to the male penis are cut and sealed by the doctor for permanent birth control. Following a vasectomy, the doctors recommend undergoing a semen analysis test once a month for three months to confirm that sperm is no longer present in the semen.
Preparation for Semen Analysis
The doctor will provide you with instructions on how to prepare for a semen analysis test. To get the best semen sample the following preparation is needed:
- Avoid ejaculating for at least 24 to 72 hours before semen collection.
- Avoid the consumption of caffeine, alcohol, or recreational drugs like marijuana and cocaine for at least two to five days before undergoing the test.
- Avoid taking any hormonal medications unless specified by your doctor.
- Stop the intake of any herbal medications.
- Discuss with your doctor if you are currently taking any medications and seek recommendations on whether to continue or discontinue the medications before the test.
Procedure for Semen Analysis
A semen sample will have to be provided to the laboratory for a semen analysis test. There are four different ways of collecting a semen sample:
- Masturbation
- Sex using a condom
- Sex and withdrawal before ejaculating
- Electricity-stimulated ejaculation
Masturbation is the most common and preferred technique used to obtain a clean semen sample.
Normal Semen Analysis Report
Once the semen sample is collected, the test results will usually be ready within one to seven days, depending on the laboratory where the test is taken. The doctor will take into account several factors while checking the semen analysis test results. An analysis done after a vasectomy will mainly look for any presence of sperm, whereas an analysis done to look for fertility problems will need a more detailed approach. The doctor will consider each of the following test results for a complete evaluation:
Sperm Count
The normal sperm count generally ranges from 20 million to just above 200 million. This number is known as the sperm density. A low sperm count indicates fertility problems that could make it difficult to conceive.
Sperm Shape
If more than 50% of the sperm are normally shaped, the test results are said to be normal. However, a man with more than 50% abnormally-shaped sperm has reduced fertility. Additionally, abnormalities in the head, midsection, or tail of the sperm can be identified using semen analysis. The presence of immature sperm can also prevent the fertilization of the female egg.
Sperm Motility
More than 50% of the sperm should move normally one hour after ejaculation. Sperm movement or motility is a vital factor that determines fertility as the sperm needs to travel to be able to fertilize the female egg. The sperm motility is rated on a scale of 0 to 4 by an automated system, where a score of 0 indicates that the sperm are not moving, whereas, a score of 3 or 4 indicates good sperm motility.
Volume
The normal volume of semen should be more than 2 milliliters. A low semen volume is indicative of less amount of sperm available to fertilize a female egg. An excess volume of semen fluid could indicate that the amount of sperm present is in a diluted state.
pH
The pH level of the semen should ideally be between 7.2 to 7.8. A pH level of more than 8.0 could indicate the presence of an infection. A pH level that is less than 7.0 could indicate that either the patient’s ejaculatory ducts are blocked or the specimen is contaminated.
Appearance
The appearance of the semen sample should be whitish to greyish and opalescent. A semen sample with a red-brown tint may indicate the presence of blood, while a yellow tint could be indicative of a medication side effect or jaundice.
Liquefaction
It should ideally take 15 to 30 minutes before the semen liquefies. Although the semen is initially thick in consistency, its ability to turn into a watery consistency or liquefy helps the sperm move. If the semen fails to liquefy within 15 to 30 minutes, fertility could be adversely affected.
Abnormal Semen Analysis Reports
A semen analysis report that shows abnormal results may indicate the presence of abnormal sperm that have trouble reaching and penetrating female eggs, making it difficult to conceive naturally. Abnormal results could be indicative of the following conditions:
- Male infertility
- Hormonal imbalance
- Infection
- Underlying diseases like diabetes
- Radiation exposure
- Genetic defects
The doctor may suggest taking additional tests if your semen analysis reports come back abnormal. The additional tests may include the following:
- Hormone testing
- Genetic analysis
- Urinalysis following ejaculation
- Obtaining a tissue sample from the testicles
- Testing of anti-sperm immune cells
A conclusive semen analysis can be obtained only after the careful collection and analysis of multiple semen samples. If your test reports are abnormal, the doctor may recommend seeing a fertility specialist.
Conclusion
A semen analysis is a type of lab test performed to check the sperm count, morphology, motility, and more. It could act as a fertility test or as a confirmatory test to check if a vasectomy was successful. Follow your doctor’s instructions carefully to provide a clean semen sample to obtain accurate results. Abnormal reports may indicate the need to undergo additional tests. The doctor may order to undergo another semen analysis to confirm the results or guide you through the next steps for proper evaluation.