Semen analysis is a test that a man is referred to by an andrologist. If you received a referral and are interested in a semen analysis, a men's health forum will hardly be of help.
Sperm mobility, sperm count and other criteria are all medical characteristics. Should one really rely on forum posters when it comes to health questions? A forum dedicated to the procedure of semen analysis can be useful in choosing a laboratory or a man's health clinic – you should read the reviews about a medical institution, prior to going there for your test.
Information about the types of criteria that must be part of the semen analysis ( normal range for a healthy male) can be found further in the article.
Why Undergo Semen Analysis?
The results of a semen analysis can help evaluate a man's health status, identify prostatitis and other infectious diseases. If you have been trying to conceive for a long time without success, testing the ejaculate for sperm count and other criteria can help find out the reasons. Semen analysis results can help a doctor prescribe an effective treatment in the event of infertility.
Semen Analysis: Testing Procedures
ccording to the recommendation of WHO (World Health Organization) semen analysis must be performed via masturbation, rather than coitus interruptus or through some other method. A special room is set up in the laboratory for the semen analysis procedure. The door there is locked from the inside. To make the ejaculate testing easier, the room contains magazines of erotic content.
If you have been scheduled for a semen analysis, the testing procedures include a 3-4 day preparation period:
1)no alcoholic beverages, including beer;
2)no sex;
3)no saunas, bath houses, or hot baths.
A repeat semen analysis intends for the individual to follow the same rules. .
In order to correctly evaluate the results of a semen analysis, it is necessary to do the test several times. Do not despair if after the initial testing, the doctor said that your semen analysis is poor . Sperm might have different characteristics after a repeat analysis. A change in these characteristics can influence the interpretation of a semen analysis as a whole.
What Is Retrograde Ejaculation?
Sometimes a man can experience an orgasm when no sperm comes out. In actuality, what happened was ejaculation into the bladder. This process is called retrograde ejaculation . If this happens, you can give a urine sample, it might contain some leftover sperm.
Semen Analysis Test: Medical Terminology
Doctors use the following terminology to describe the sperm:
- azoospermia — no sperm were found in the ejaculate;
- akinospermia — sperm is completely immobile;
- antisperm antibodies (ASA) — antibodies produced by the body against the sperm;
- asthenozoospermia — insufficiently mobile sperm (category А<25% or А+В<50%);
- hemospermia — the ejaculate contains red blood cells;
- leukospermia — increased numbers of white blood cells (over 1 mil/ml);
- necrospermia — no live sperm;
- normozoospermia — there are several deviations from the norm, but they have no effect on fertilization;
- normospermia — all sperm criteria are within normal range;
- oligozoospermia — provides evidence of small sperm count (concentration is less than 20 mil/ml);
- oligospermia — insufficient semen volume (less than 2 ml);
- teratozoospermia — increased number of abnormal sperm (over 50%).
Normal Range for Semen Analysis
|
Criterion |
Normal range |
|
Semen Examination |
|
|
Liquefaction time |
10–60 minutes |
|
Volume |
2.0–6.0 ml |
|
рН |
7,2–8,0 |
|
Color |
Normal sperm colors are whitish-gray, milky, yellowish |
|
Sperm count in the ejaculate |
40–500 mil |
|
White blood cell count |
no more than 1 mil/ml |
|
Red blood cell count |
none |
|
Mucus |
absent |
|
Sperm Assessment |
|
|
Concentration (number of sperm in 1 ml) |
20–120 mil/ml |
|
Rapidly progressive (category А) |
over 25% |
|
Slowly progressive (category В) A+B |
over 50% |
|
Non-progressive (category С) |
less than 50% |
|
Immotile (category D) |
no more than 6–10% |
|
Proper morphology |
over 50% |
|
Agglutination |
none |
|
MAR test |
less than 50% |
Some believe that normospermia and normozoospermia are the same thing. In reality, that is not so. With normozoospermia certain criteria, such as liquefaction of the ejaculate, рН, or viscosity can deviate slightly from the norm. This does not affect fertilization.
Semen Analysis Interpretation
- Ejaculate liquefaction time а
Normozoospermia presumes sperm liquefaction within 10–60 minutes after ejaculation.
During ejaculation sperm is suspended in a mucus-like state. Sometime later, prostate enzymes located in the seminal fluid liquefy it. If the sperm does not liquefy, it indicates a prostate disorder. Consequently, the chemical composition of sperm is abnormal. This affects sperm motility and their ability to fertilize an egg. Insufficient liquefaction can lead to abnormal sperm motility indices.
- рН
Following ejaculation , sperm can be killed in the acidic medium of the vagina. For sperm to be able to fertilize an egg and safely pass this "barrier", it needs to have protection. Seminal fluid acts as just such a protection: it decreases vaginal acidity, and sperm can get to the uterus "alive".
If all semen analysis criteria are normal except for рН, it does not indicate that there are any deviations. Yet in conjunction with other characteristics it can affect the diagnosis.
With azoospermia decreased рН levels point to blocked ejaculatory ducts.
- Volume of seminal fluid
Normospermia — 2,0–6,0 ml sperm.
Insufficient volume of the ejaculate also contains small number of sperm. If the test showed that you have oligospermia, in other words, that insufficient number of sperm are released during ejaculation (less than 2 ml), it can be the cause of infertility.
Small volume of seminal fluid is also incapable of providing long-term protection for sperm from the acidic medium of the vagina and of helping them make their way to the uterus.
In order to confirm the diagnosis of oligospermia, you would need to perform seminal fluid analysis several times. Even if the volume was less than 2 ml the first time, it is not yet cause for concern.
If during ejaculation you release more than 6 ml of sperm, it will not do anything to hasten conception. The reason is that only about 5 ml of sperm can fit into the vagina. If more sperm are released during ejaculation, extra ejaculate leaks out and does not take part in the race.
- Semen color
What color is a healthy man's semen ?
In most cases semen color is whitish-gray (normospermia).
Yellowish, milky, or white milky semen color is also within normal range ( normozoospermia). The aforementioned colors do not indicate the presence of any deviations. WHO recommends not taking into account semen color or its smell.
Some laboratories, however, still record that characteristic.
Thus, pinkish semen color indicates an increased number of red blood cells in the ejaculate ( hemospermia). With hemospermia, semen color may even have a brownish tint.
Transparent semen color indicates azoospermia (semen does not contain any sperm).
- White blood cells
Normospermia assumes the absence of white blood cells, and normozoospermia assumes the quantity of no greater than 1 mil/ml.
Seminal fluid analysis can indicate that seminal fluid contains a small number of white blood cells. If their concentration is less than 1 mil/ml, it is normal. Increased white blood cell count (leukospermia) points to inflammation in the prostate or the seminal vesicles.
- Red blood cells
There should be no red blood cells with the diagnosis of normospermia.
Semen analysis is bad, if your semen contains red blood cells. Hemospermia is often observed in semen analysis following an injury, tumor, or prostatitis. Crimson blood color in the semen (false hemospermia) points to an injury or a urethral disease.
With hemospermia semen is brownish or dark-red color. When semen released during ejaculation is either of those colors, it is a sign of serious reproductive system disorders. It can be caused by inflammation of the urinary bladder, seminal vesicles, or the prostate.
Hemospermia in elderly men can by a symptom of prostate cancer. Recent investigations showed a connection between hemospermia and prostate cancer: 14% of the patients with hemospermia had cancer.
Hemospermia requires individual approach to treatment. A doctor also has to take into account the patient's age, the length of manifestation of hemospermia symptoms and the frequency of their emergence.
- Mucus
Presence of mucus in the semen precludes the diagnosis of normospermia. If during ejaculation semen contains mucus, it is a sign of inflammation in the reproductive organs.
- Concentration
The acidic medium of the vagina kills the small number of sperm that are released during ejaculation. Consequently, even they don't have time to make it to the uterus alive. Low sperm concentration (oligozoospermia) can be the cause of infertility.
With azoospermia sperm count equals zero.
- Sperm motility
Native semen (untreated) can contain four categories of sperm :
Category А
If sperm moves in a straight line and passes about half of its length in one second (about 0.025 mm/sec), it is classified as category A sperm. About half of all category A sperm are healthy, young sperm that were recently formed in the testes.
Category В
B category sperm move in a straight line but their speed is less than 0.025 mm/sec. There is generally 10-15% of such sperm during ejaculation. These are either aging sperm or sperm with abnormal structure.
Decreased sperm motility can be tied to prolonged abstinence from sex.
Category С
If sperm spin in place or in a circle, they are classified as category C. Their number is generally between 5 and 15%.
Category D
This category includes the number of sperm that do not move at all (azoospermia). Roughly 50% of all category D sperm are old sperm that have either already died or are in the process of dying.
Even if you are perfectly healthy and you were diagnosed with normospermia or normozoospermia, semen analysis can reveal all four types of sperm.
If you have akinospermia, it is essential to find out what causes sperm immobility . Eosin is used for that purpose. When placed in that substance, dead sperm cell takes on a red color: its membrane breaks up and eosin easily penetrates inside. If sperm neither colors nor moves, it indicates abnormal sperm morphology.
Occasionally all sperm released during ejaculation are dead – that is called necrospermia. It can be false or true. The causes of true necrospermia have not been fully ascertained – it does not respond to treatment. With partial necrospermia, there are less than 20% of live sperm.
If a doctor diagnoses necrospermia following several interpretations of semen analysis, this married couple is advised to either choose adoption or artificial insemination with donor sperm.
Sperm: he structure of normal and abnormal forms
- Sperm morphology
In order to be able to exclude infertility, it is important to know how many sperm have normal and abnormal structure (morphology). Abnormal sperm (with abnormal structure) move slower and have lower tail beat frequency. Stained smear and untreated — native — semen are used to reveal abnormal sperm.
- Sperm agglutination
Sperm agglutination is the clumping of sperm. It points to inflammation in reproductive glands and immune system disorders. In most cases, it is possible to naturally conceive a child with sperm agglutination. Yet sperm agglutination almost always reduces sperm motility.
- ASA
ASA are group A, M and G immunoglobulins (proteins) group А, М и G. Antisperm antibodies sperm binds with another. ASA are formed in men's and women's bodies.
ASA can cause infertility. If sperm tail binds with ASA, it begins to move slower; if it binds with its head, it cannot fertilize an egg. MAR test (mixed immunoglobulin reaction) is most often used to identify them in the ejaculate. If your semen analysis test has zero in the MAR test column, it means that no ASA were discovered.
Causes of Sperm Immobility
If the test reveals immobility or very low sperm motility, this can have the following causes:
- alcoholic beverages;
- tight underwear;
- diseases of reproductive organs;
- smoking (of tobacco, marijuana, etc.);
- personal lubricants;
- vitamin deficiency;
- stress.
Low sperm motility can also be associated with abnormal sperm structure.
How to Increase Sperm Motility
When body temperature increases and ejaculation, takes place, a certain increase in sperm motility is observed, while sperm motility is decreased at room temperature. Consequently, semen analysis interpretation directly depends on the conditions during testing. If the test is conducted in a room where temperature is 10 °С, even healthy young sperm will have low sperm motility .That is why special hot benches are used in the labs for this analysis, which maintain the temperature that approximates that of the body.
The female partner's ability to conceive is greatly decreased if a doctor diagnoses asthenozoospermia. Yet even an increase in sperm motilityis not a 100% guarantee of pregnancy.
Your doctor will tell you how to increase sperm motility. Antioxidant regiments that binds free radicals in the body help improve sperm motility.
British researchers tried to find out how to increase sperm motility . Several men, who could not conceive a child over a period of two years, took part in an experiment conducted by BBC. Following the semen analysis test, men were diagnosed with teratozoospermia– a large number of abnormal sperm. Low sperm motility was also observed in their seminal fluid.
A dietician developed a nutritional system with a large quantity of antioxidant vitamins for the experiment participants. Men drank a glass of fruit or vegetable juice every morning and evening. After three months of that diet, the specialists observed an increase in sperm motilityin the repeat semen analysis of the subjects..
Six months after the start of the experiment, men not only lost sperm immobility – a female partner of one of them even managed to conceive. Based on the results of the semen analysis, the specialists observed improvement in sperm motility in all experiment participants.
At the end of the experiment, the British scientists concluded that taking antioxidant vitamins not only improves sperm morphology but also increases sperm motility.
Talk to your doctor if you do not know how to increase sperm motility.
