Semen Analysis: Everything You Need to Know About Evaluating Male Fertility

Author's picturewritten by ZapppelphilipppAugust 1, 2024
Semen analysis - machine analyzing sperm

A semen analysis, also known as a sperm analysis, is an essential test for evaluating male fertility. This article provides a comprehensive overview of the test, its procedure, and how to interpret the results. A semen analysis examines both the quality and quantity of sperm, which is crucial for assessing male fertility.

What is a Semen Analysis?

A semen analysis assesses the quality and quantity of sperm in a semen sample to determine a man's fertility. This test is often conducted when a couple has not achieved pregnancy after a year of unprotected intercourse. The analysis of sperm and fertility testing are crucial in such cases to identify potential issues with male fertility.

When is a Semen Analysis Performed?

A semen analysis is often recommended if a couple has not conceived after a year of unprotected sex. It helps identify issues such as sperm quality or quantity. A semen analysis is also performed after a vasectomy to confirm the success of the procedure. This fertility test is relevant in cases of infertility and for those trying to conceive.

Cost of a Semen Analysis

The cost of a semen analysis typically ranges from 60 to 90 euros. If medically necessary, health insurance often covers these costs. It is advisable to check with your insurance provider in advance to understand the cost structure associated with this fertility test.

Procedure for a Semen Analysis

To conduct a semen analysis, you consult a urologist or a fertility clinic. The semen sample is analyzed in the lab. Important steps for collecting the sample include:

  • The sample is collected through masturbation.
  • Hands and penis should be washed without using disinfectants before collection.
  • Avoid using lubricants as they can affect sperm motility.
  • It is crucial to collect the entire ejaculate in the container.
  • Abstain from ejaculation for three to five days before the test to ensure an optimal sperm count.

Home Collection for Semen Analysis

If you feel uncomfortable collecting the sample on-site, you may be able to collect it at home. Consider the following:

  • Use a special transport container provided by the doctor.
  • Transport the sample without cooling, for example, close to your body.
  • Ensure the sample reaches the doctor within 60 minutes.

Collecting a Semen Sample During Intercourse

A semen sample can also be collected during intercourse using a special transport condom provided by the doctor. This is an alternative method for obtaining a sample for the fertility test.

Laboratory Analysis of the Semen Sample

In the lab, the semen sample is examined for appearance, volume, consistency, and pH value. Under the microscope, the number, motility, and morphology of the sperm are analyzed. These values help the urologist assess fertility. The minimum values set by the World Health Organization (WHO) are:

  • Ejaculate volume: 1.5 milliliters
  • Cells per milliliter: 15 million
  • Total sperm count: 39 million
  • Motility: 40%
  • Progressive motility: 32%
  • Living sperm: 58%
  • Morphologically normal sperm: 4%

How Long Does a Semen Analysis Take?

A semen analysis usually takes about 1 to 2 hours. Results are typically available within 1 to 2 days, depending on the lab and their processing time. It can be helpful to inquire about the exact duration in advance to plan accordingly.

Interpreting Semen Analysis Results

The WHO has established the following minimum values to determine male fertility:

  • Ejaculate volume: 1.5 milliliters
  • Cells per milliliter: 15 million
  • Total sperm count: 39 million
  • Motility: 40%
  • Progressive motility: 32%
  • Living sperm: 58%
  • Morphologically normal sperm: 4%

Dealing with Low Sperm Count

A low sperm count does not necessarily indicate infertility. The urologist may perform additional tests, such as hormone analyses. If needed, assisted reproductive techniques like intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) can be considered. Targeted measures can also improve a low sperm count.

Causes of Abnormal Semen Analysis

Various factors can lead to an abnormal semen analysis:

  • Medications and illnesses: Certain medications and illnesses, such as hormonal imbalances, infections, or genetic factors, can affect sperm quality.
  • Environmental factors: Exposure to environmental toxins, such as pesticides or heavy metals, can negatively impact sperm quality.
  • Lifestyle: Factors such as excessive alcohol and tobacco consumption, stress, and an unbalanced diet can reduce sperm quality.

Improving Sperm Quality

A negative test result is not the end. Lifestyle changes can improve sperm quality:

  • Moderate alcohol consumption: Excessive alcohol consumption lowers testosterone levels and affects sperm quality.
  • Avoid smoking: Nicotine reduces blood flow to the testes and decreases sperm production.
  • Healthy diet: A nutrient-rich, low-fat diet with omega-3 fatty acids and vitamins C, zinc, and selenium improves sperm quality.
  • Weight management: Being overweight can negatively affect sperm production.
  • Regular physical activity: Moderate exercise can improve sperm quality.

Further Examinations for Male Infertility

Depending on the findings, additional tests may be considered. The following procedures can be applied based on the indication:

  • Sonography: Ultrasound of the testes and prostate, especially if a tumor is suspected.
  • Biopsy: To check spermatogenesis (development and maturation of sperm).
  • Blood tests: Especially if genetic disorders are suspected.

What If the Semen Analysis Is Unremarkable?

If the results of the semen analysis are unusual or do not meet normal values, the doctor may order additional tests or a more detailed examination. This may include further diagnostic procedures to identify the causes of the abnormalities and determine appropriate treatment options.

Can a Semen Analysis Produce False Results?

Yes, various factors such as stress, improper sample collection, or other external influences can affect the results of a semen analysis. It is important to collect the sample under the right conditions and consider repeated tests to ensure accurate and reliable results.