When the desire to have children remains unfulfilled, couples often find themselves in a period filled with questions and uncertainties. A sperm analysis can provide initial answers and help identify potential reasons for the lack of pregnancy. In this article, you will discover what a sperm analysis entails, how the test is conducted, and which values are important in the evaluation. Additionally, we will outline the steps you can take to improve your results or pursue further diagnostic measures.
What is a Sperm Analysis?
A sperm analysis is a laboratory test used to evaluate male fertility. Specialists examine various parameters in a semen sample, specifically:
- Sperm Count: How many sperm are present per milliliter of ejaculate?
- Motility: How active are the sperm in their movement?
- Morphology: What is the shape of the sperm, and what percentage are normally shaped?
- Ejaculate Volume: How much fluid is produced in total?
These values provide an initial assessment of whether a man's sperm are sufficiently functional to fertilise an egg.
When is a Sperm Analysis Recommended?
A sperm analysis is often recommended if no pregnancy occurs after a year of regular unprotected sexual intercourse. Additionally, the test is advisable in other scenarios, such as:
- Suspected hormonal imbalances or following abnormal blood test results.
- Before or after a sterilisation (vasectomy) to confirm its success.
- In cases of repeated miscarriages to identify possible causes.
Costs and Reimbursement
The cost of a sperm analysis typically ranges between €60 and €90. If there is a medical indication, such as an unfulfilled desire to have children, statutory health insurance usually covers the costs. Private health insurers may handle this differently – it is advisable to enquire in advance.
Procedure of the Sperm Analysis
1. Preparation
To ensure the most accurate results, please adhere to the following recommendations:
- Avoid ejaculation for 3–5 days prior to sample collection.
- Refrain from consuming alcohol and nicotine in the days leading up to the submission.
- Minimise stress and ensure adequate sleep.
2. Sample Collection
The sample is usually collected through masturbation in a private room within the clinic or laboratory. Please ensure:
- Thoroughly cleanse your hands and penis with water and soap (do not use disinfectant).
- Do not use lubricants, as they can alter sperm quality.
- Collect the entire ejaculate in a sterile container provided by the laboratory.
Alternatively, you may collect the sample at home. In this case, it is essential to maintain body temperature during transport (e.g., in a jacket pocket) and submit it to the clinic or laboratory within a maximum of 60 minutes.
Laboratory Examination: Which Values Are Measured?
The semen analysis is conducted under a microscope and involves various tests. According to the guidelines of the World Health Organisation (WHO), the following parameters are particularly crucial:
- Ejaculate Volume: At least 1.5 ml.
- Sperm Concentration: At least 15 million sperm per milliliter.
- Total Count: At least 39 million sperm per ejaculate.
- Motility: At least 40 percent of sperm are motile.
- Morphology: At least 4 percent of sperm are normally shaped.
These reference values serve as guidelines. Minor deviations should be evaluated on an individual basis and do not necessarily indicate infertility.
Duration of the Analysis and Discussion of Results
The actual analysis typically takes 1–2 hours. Subsequently, the laboratory processes the data, so the complete report is usually available within a few days. Your doctor will discuss the results with you and explain whether further examinations or treatment steps are advisable.
Interpretation of the Findings
If there are deviations from the reference values, medical professionals generally refer to the following conditions:
- Oligozoospermia: A sperm concentration that is too low.
- Asthenozoospermia: Reduced sperm motility.
- Teratozoospermia: An excessive number of abnormally shaped sperm.
- Azoospermia: No sperm detected in the ejaculate.
In any case, it is important to thoroughly investigate the potential causes. These may include hormonal imbalances, genetic factors, infections, or unfavorable lifestyle habits.
Common Causes of Abnormalities
Sperm production can be affected by a variety of factors. For example:
- Hormonal Disorders: Imbalances in testosterone, follicle-stimulating hormone, or luteinising hormone.
- Genetic Causes: Chromosomal anomalies or hereditary diseases.
- Infections: Such as sexually transmitted infections.
- Lifestyle: Smoking, alcohol consumption, obesity, and stress.
- Environmental Factors: Exposure to pollutants, excessive heat, radiation, or chemicals.
Often, doctors recommend repeating the sperm analysis to rule out possible measurement errors or short-term influences such as fever or infections.
Optimising Sperm Quality
Inadequate semen quality does not have to be a definitive diagnosis. Many men can improve their sperm parameters through targeted measures:
- Diet: Maintain a balanced diet rich in fruits, vegetables, whole grains, and proteins.
- Exercise & Physical Activity: Engage in moderate, regular activity to boost metabolism.
- Reduce Smoking & Alcohol: Toxins can impair sperm production.
- Stress Management: Techniques such as yoga, meditation, or autogenic training can have positive effects.
- Minimise Heat Exposure: Avoid tight underwear and frequent sauna visits, as excessive heat can damage sperm.
Additionally, medical treatments such as hormone therapy or targeted infection treatments may be beneficial, depending on individual findings.
Further Diagnostics and Fertility Treatment
If the results show significant abnormalities, further tests may be necessary. These include:
- Hormone Analyses: Measuring levels of testosterone, follicle-stimulating hormone, luteinising hormone, and prolactin.
- Genetic Testing: Checking for chromosomal abnormalities.
- Ultrasound: Examination of the testes and epididymis.
- DNA Fragmentation Test: Assessing the genetic quality of the sperm.
If significantly impaired values are present, assisted reproductive technologies such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) may be considered.
What if the Sperm Analysis is Normal?
Even if the sperm analysis shows no abnormalities, pregnancy may still not occur. In this case, potential issues on the female partner's side should also be investigated, such as menstrual cycle disorders or hormonal imbalances. A joint counselling session at a fertility centre can provide clarity and outline further steps.
Conclusion
A sperm analysis is an essential step in evaluating male fertility. It provides valuable insights into key parameters such as sperm count, motility, and morphology. If the values fall outside the normal range, there are numerous ways to address this proactively – from lifestyle adjustments to specific medical treatments. Should pregnancy remain elusive despite normal results, a comprehensive examination of both partners is advisable. This approach brings you closer to fulfilling your desire to start a family.