All About Semen Analysis

How do you know that your sperm count is normal? Any count above 15 million /ml or 39 million per ejaculate is normal If semen is 2.5 ml and sperm count per million is 20 million then per ejaculate there are 50 million sperms. Hence the volume also is of significance There is no upper limit to normal.

Does a normal sperm count assure a pregnancy? Now if you have a count above 15 million it means that the number of sperms are normal but fertility is also dependent on whether those sperms are motile and normal in shape. So you have to look at the complete semenanalysis before a conclusion can be made. You also have to look at female factors. If everything is normal the chance of getting pregnant is 20% per month and is called the fecundity rate.

Why do you need millions of sperms for fertility when just one egg is to be fertilized? Since sperm is deposited in vagina many sperms may be needed before they can reach the egg which is released from the ovary and then moves to the fallopian tubes.

How do I interpret the other terms in my semen analysis?

Motility : There are three terms – Progressive motility, non progressive motility and non motile

Progressive motility means that not only is the sperm moving but it is travelling forward with that movement. This is the sperm which can fertilize the egg by moving forward to reach it and then enter into the egg. Non progressive motility means that the sperm is motile but only stationary in one place. Hence it cannot move forward to reach the egg. This sperm however can be used in IVF to inject the sperm directly in the egg (ICSI). So in men with only non progressive motility IVF-ICSI is needed. Non motile means it is not moving. It can be dead or alive. There are further tests which can test if the sperm is alive. There should be at least 40% sperms which are motile and 32% progressively motile for a semen analysis to be termed normal.

Morphology: This means the shape of the sperm which is assessed for being normal. The sperm consists of a head midpiece and tail

  • The head of the sperm holds the DNA of the cell. …
  • The midpiece of the sperm is packed with organelles which produce energy. …
  • The tail of the sperm moves like a propeller, and is responsible for sperm movement.

Any defect in shape of any of the parts of the sperm can cause a decreased fertility. There could be a small head, large head, pyriform shape, double head. Tail could be curved or double or too short

What can be the cause of poor semen analysis?  Poor number motility and shape can be because of smoking, infections, by birth, certain medications, due to some problems in the brain not producing the right hormones, a varicocele ie dilated blood vessels, obesity and poor lifestyle and diet, testicular failure because of undescended testis, trauma to testis

What can you do to improve things without visiting the doctor?

  • Lose weight. a healthy lifestyle with a good diet and exercise.
  • A poor diet and lack of vitamins can cause a poor semen hence Take vitamin supplements. Ask your doctor for a blood test to test for vitamin deficiencies.
  • Avoid habit forming drugs, heavy drinking or smoking.
  • Wear loose, no hot baths

Should I depend on a single semen test ?It is recommended that at least 3 tests should be done to confirm a poor sperm count.

What are the errors which can occur during semenalysis to give a false report and are they preventable? The errors which can occur could be at your end or it may be due to the lab.

  1. The period of abstinence (the time from last intercourse) – if the period is more than 7 days motility and morphology may be less. If the period is less than 48 hours ( 2 days) then the count may be less and motility better. This is because the sperm when stored for long periods >7 days gets damaged leading to an abnormal and slow sperm
  2. Faulty collection: Washing with soap, or collecting in a condom or a plastic box which may be toxic to the sperm leads to more dead sperms. Sometimes while collecting there is spillage leading to a low sperm count. This must be recorded
  3. Excessive time taken to give sample to lab: If sample is being taken at home and it takes more than 40 minutes to reach the motility of the sample can be compromised.
  4. Laboratory issues: If semen analysis is done in a pathology lab staff may be untrained and give a wrong report. Doing morphology requires specialized training and usually technicians in an IVF lab are trained. Hence it is always better to confirm your findings in an IVF lab. General lab staff is too busy with other samples to give appropriate time to do semen analysis

What is the next step if there are no sperms?

  1. Ensure collection has been done in a right manner
  2. Repeat test and ask lab to centrifuge sample ( a method which concentrates any sperms to the bottom of the test tube) and then see again
  3. Retest again after 6 weeks

How can you improve sperm count?

  1. Smoking: Smoking is known to decrease sperm counts and motility. It is seen that the impact of smoking is dependent on number of cigarettes consumed. It has been observed that men who smoked more than 15 cigarettes a day had a 20% reduction in sperm concentration.
  2. Diet: A deficiency in antioxidants may lead to poor sperm motility and morphology. Hence, fresh fruits and vegetables rich in antioxidants, a high protein diet helps. Also eating omega 3 fatty acids helps. count. A diet rich in antioxidants like carotene, CoQ, lycopene, Vit E & C, It has been found that antioxidants prevent DNA damage in sperms. Diet which is specific to sperm health should be given
  • Vitamin C: Lemon, Orange.
  • Vitamin E: found in nuts, oils, and spinach
  • Folic acid: Green leafy vegetables.
  • Selenium: tuna, nuts, and chicken.
  • Lycopene: found in tomatoes, bell peppers and watermelon.
  • Zinc: chicken, meat.
  • Good sleep: Sleep helps to rest the body and alleviate stress and inturn helps sperm parameters to improve
  • Exercise: It has been seen that aerobic exercises for 45 minutes on alternate days has been helpful in increasing semen volume and sperm counts.
  • Stress reduction: This can be done through meditation, yoga and exercise. In case anxiety levels are high counseling and anti anxiety drugs may be given
  • Loose weight as it disturbs the hormones if a man is overweight. Overweight men have a 2-3 times more chance of a lower sperm count.
  • Vitamin supplements and antioxidants – Vit C , Vit E, CoQ 300, lycopene
  • Alcohol and drugs: It is better to limit consumption of alcohol. Marijuana and cocaine have been known to impact semen parameters
  • Treat General Health Conditions: Any chronic ill health like diabetes , hypertension Kidney disease can impact fertility and must be treated
  • Stop Medication causing infertility:
  • Avoiding drugs treatment which have adverse effects on sperm count: These are antibiotics , exogenous testosterone supplements, anabolic steroids, anti psychotics, Some medication for high blood pressure, depression chemotherapy cause lowering of sperm count. Testosterone used for body building drastically lowers sperm counts and it may take months and years to come back. These medications must be stopped
  • Avoid eating too much soya: This contains phytoestrogen and disturbs the hormonal balance in males
  • Avoid environmental toxins: Chemicals and certain organic compounds may be harmful. Painter, Varnishers, metal workers, miners, farmers may be affected– for the chemicals they use which can be toxic to the sperm
  • Avoid hot baths and tight under-wears which decrease the sperm count by increasing local temperatures
  • Treat any infections in genital tract like prostitis ( which manifests with pain during passing urine)
  • Treat dilated veins in the testis ( varicocele)-by Operating
  • Hormonal treatment – Contact your doctor to see if you require it.
  • Genetic tests –If Sperm counts are very low – genetic tests like Karyotyping and Y chromosome microdeletion must be done.
  • Surgical sperm retrieval : If there are no sperms you may need to have a needle aspiration or biopsy from the testis to retrieve sperm

If none of this work you would need an IVF. Contact a good IVF centre which has expertise in male infertility. Get a Free Consult with Dr. Surveen on male infertility. Contact Now!

Leave a Comment

Your email address will not be published. Required fields are marked *

Covid-19 Icon

Worried about IVF during covid? Do a tele-consultation with Dr Surveen