Sperm count analysis:
The semen analysis or sperm count analysis is an essential fertility test for men. Semen analysis is one of the first tests done to evaluate a man's fertility. About half of the couples unable to have children have a male infertility problem.
Semen analysis evaluates certain characteristics of a male's semen and the sperm contained in it.
Let’s start with the basics: Semen and sperm is not the same thing.
Sperm is just one of the many components of semen. The other elements are to help the sperm in reaching the egg. These other parts help the sperm by its mobility, lubrication, and even by reducing the resistance of the egg to the sperm.
A typical male produces from 2 – 6 mL of semen when ejaculating.
What is semen?
Semen is a white or grey liquid, sometimes yellow in color, emitted from the penis on ejaculation through the urethra. Usually, each milliliter of semen contains millions of sperm, but most of the volume consists of secretions of the glands in the male reproductive organs.
Pink or red semen suggests that blood is present. Men with semen that seems bloodstained should find advice by a doctor.
Semen clots almost immediately after ejaculation, forming a sticky, jelly-like liquid. It will liquefy again in 5 to 40 minutes. It is normal for semen to form jelly-like globules which does not indicate any health or fertility problems. Within about 1 minute after ejaculation, the ejaculate undergoes coagulation. This coagulum temporarily restricts movements of sperm out of the seminal clot. After about 5 to 40 minutes, a seminal-fluid proteolytic enzyme produced by the prostate gland gradually liquefies the clot. At this time, motile sperm may move again without restrictions.
Overview of the male reproductive system
The function of the male reproductive system is to produce, store and transport the sperm outside the body. The organs that produce sperm are the testes. Sperm is produced by the testes and is stored in the epididymis. The epididymis is a reservoir in the back of the testicles. From this reservoir, the sperm travels upstream (through the vas deferens) by the ejaculatory ducts where it will be ready to leave. Sperm production begins with immature sperm cells that grow and develop within the seminiferous tubules. These tubes are very tiny and the sperm inside them are not fully mature. As a result they are unable to move on their own. As they travel along the length of the epididymis they mature and become motile. During ejaculation they are carried from the epididymis to the penis along the vas deferens.
Semen analysis or sperm count analysis:
Semen is the thick, white fluid released during ejaculation that contains sperm.
A semen analysis measures three major factors of sperm health:
The sperm number (count)
The sperm shape (morphology)
The sperm movement (motility)
Normal semen analysis: Normal WHO reference range for sperm count:
The World Health Organization provides a definition of a 'normal' sperm count:
The total volume of semen should be at least 1.5 ml (1.5 – 7.6 ml).
The number of sperm should be at least 15 million/1ml (≥ 15M/1ml).
The total number of sperm in the ejaculate should be at least 39 million (≥ 39M/ejaculate).
At least 58% of the sperm should be live (≥ 58% alive).
At least 4% of the sperm should be of normal shape and form (≥ 4% normal morphology).
At least 32% of the sperm should be swimming with rapid forward + slow movement at 1 hour and at 4 hours (Rapid + Slow progressive motility ≥ 32%).
At least 40% of the total sperm should be swimming forward, even if only sluggishly at 1 hour and at 4 hours (Rapid + Slow + Sluggish ≥ 40%).
How to prepare for the semen analysis or sperm count test:
You’ll make an appointment to either produce your sperm sample in the lab or to bring it with you to the clinic or lab after you produce it at home.
You have to stop any sexual activity for at least 2 - 3 days, but not more than five to seven days before your sperm sample is collected. This means no sex or no ejaculation of any kind, including masturbation. Longer or shorter periods of abstinence may result in a lower sperm count, or decreased sperm motility or movement. Samples produced after 2 - 3 days of abstinence will usually have the highest numbers of motile sperm with the greatest forward velocity when compared to samples produced after shorter or longer periods of abstinence. Some men think saving up all their sperm for the day of their test. Waiting too long between ejaculations is a big mistake; older sperm begins to die if ejaculations aren’t frequent and the percentage of live sperm decreases with increased abstinence.
Specific substances that could affect the quality of the sperm sample include:
Cimetidine (Tagamet), male and female hormones (Testosterone, Estrogen), Sulfasalazine, Nitrofurantoin, and some chemotherapy medications.
Caffeine, alcohol, cocaine, marijuana, and tobacco. Anabolic steroids can also affect sperm production.
Herbal medicines, such as St. John’s Wort and high doses of Echinacea.
Methods for collecting a sperm sample:
Masturbation is, most likely, the way you’ll collect your semen specimen. Most doctors recommend you ejaculate directly into a provided sterile cup and not use a condom.
If you want to use a condom by intercourse, the lab will give you a special semen collection condom (that does not contain spermicide).
There are a few rules for collecting your semen sample:
First make sure that your hands and penis are clean. Wash them with soap and then rinse them with water.
You cannot use any lubricant unless provided by the clinic. This includes saliva. And, as mentioned, don’t collect your semen in a condom (the spermicidal agents will change the results of the analysis).
You have to ejaculate directly into a sterile container given by your clinic or lab. Don’t touch the inside of the cup and try to get the first part of your ejaculation in the cup, because it is thought to be the most sperm-rich. If any semen spills, do not try to put it into your cup.
As soon as you collect your sample, put the lid on the container. Make sure your name, date of birth, time and date of your sample is clearly written on the cup. Many clinics will put a sticker with your info on the cup or lid. Be sure to check that it is correct.
Transporting Your Semen
If you collect your sample outside the clinic, you need to deliver it to the laboratory within 30 minutes - 1 hour after ejaculation. Sperm does not have a long life outside of the body or in environments with fluctuating temperatures. Delays in delivering the semen sample and exposure to various temperatures will result in lower motile sperm count and poor semen cryopreservation.
The semen sample should be kept as close to body temperature as possible. If the sample is collected at home, keep it in the inside pocket so that it will stay at body temperature while you are transporting it. The sperm motility will be inaccurately low if the semen sample gets too cold or if it gets too hot. Keep your specimen container upright with the lid securely tightened.
The earlier the sample is analyzed, the more reliable the results.
Most clinics will ask to you produce the sperm sample inside the clinic to be sure that this is your own sperm and that you are able to produce a sample for a fertility cycle and to get the best possible sample.
Where to produce the sperm sample?
Most likely you will be in a room that is for sperm sample collection at the clinic. The room is usually inspiring. But you might bring your own inspiring videos on your smartphone.
The following things in a sperm count will be evaluated:
• How the semen thickens and becomes solid and then changes to liquid
• Fluid thickness, acidity, and sugar content
• Resistance to flow (viscosity)
• Movement of the sperm and velocity (motility)
• Number of the sperm found in 1 ml and in the whole ejaculate (sperm count)
• Morphology (form or shape)
• Total volume of the semen