Subfertility and infertility can be due to a defect in the male or female reproductive systems. Therefore, it is imperative that both partners are investigated for possible subfertility. The mainstay of male subfertility assessment is analyzing the semen to find any defects. Seminal fluid analysis can identify problems with the count of sperms (quantitative) and their overall quality (qualitative). Semen analysis acts as a potency test for males.
The fertility test for males
The process of analyzing the semen begins with an appointment at the fertility center. A fertility expert first performs a detailed interview of the couple. Both partners are investigated in order to ascertain the depth of the problem.
Preparation for seminal fluid analysis requires;
- Avoiding ejaculation for 24 to 72 hours.
- Abstaining from alcohol, caffeine for two to five days.
- Avoiding herbal medications.
- Avoiding hormone medications.
- Abstaining from intercourse and use of spermicide.
- Discussing with your doctor the potential effects of your daily medications, if any, on seminal fluid analysis.
The test is performed on three samples taken more than seven days apart and over the course of three months.
Analysis is performed on a semen sample collected through masturbation. On the other hand, a testicular biopsy is performed in males who have serious illnesses. This sample collection is done in an extremely private setting. If collected at home, the sample must be kept at body temperature and transported to the laboratory within 60 minutes of collection.
The fertility laboratory assesses the sample for the following,
- Morphology – The sample is considered normal if more than 50% sperm have a normal appearance.
- Movement/Sperm Motility Test – More than 50% sperm moving normally after an hour of collection indicates a normal sample. Highly motile sperm are essential for the process of fertilization.
- pH – The pH should be between 7.2 and 7.8 for a normal sample. Reduced or increased pH values indicate infections or structural blockage of the ducts which carry sperm in the male body.
- Volume – A volume of greater than 2ml is considered normal. Low volumes indicate a low sperm count. Since chances of fertilization greatly increase with the volume of sperm, low volume points towards obvious subfertility.
- Liquefaction – Initially thick, the semen has the ability to liquefy and attain a watery consistency; this helps the sperm move. This usually happens within 15 to 30 minutes. Slow liquefaction, on the other hand, can affect a male’s fertility.
- Sperm count – The normal sperm count is between 20 million to 200 million per milliliter of semen.
- Appearance – The normal appearance of semen is whitish and opaque. A brownish or yellow tint indicates a problem in the testicles or ducts that transport the semen.
Causes of abnormal seminal fluid analysis report
- Infections
- Hormonal imbalances
- Medical illnesses such as diabetes
- Gene defects
- Radiation exposure
- Improper collection
Abnormal seminal fluid analysis
If a definitive cause cannot be identified then further testing might be required. Below are some other tests that can be recommended,
- Hormone testing – To check for any hormonal imbalances.
- Genetic testing – To detect any genetic defects that might hamper sperm production.
- Post-ejaculation urinalysis – To see if there are structural abnormalities that cause the sperm to be sent into the bladder instead of being ejaculated.
- Testicular Tissue Sample – To check for anomalies in the production of sperm.
- Anti-Sperm Immune Cells Testing – To check for immunity-related destruction of sperm.
Couples who have had recurrent miscarriages or less success in treatment cycles should be investigated with SCSA (Sperm Chromatin Structure Assay). This is used to see if there are broken or fragmented DNA strands in the sperm. Sperm with damaged DNA is likely to suffer from an abnormal structure and functioning, which can lead to a miscarriage.
However, abnormal tests do not necessarily mean the end of your fertility aspirations. Newer methods of treatment have been introduced while tons of others are in the pipeline, which can help fulfil the desire of fathering your own child.