It is estimated that between 20-30% of males are affected with infertility. It is essential therefore that we perform a semen assessment to understand if the quality of your sperm is negatively affecting your fertility.
For an accurate assessment of your semen sample, we require you to abstain from sexual intercourse or ejaculation for 2-5 days prior to the test. A semen analysis test measures multiple different parameters within a semen sample:
The volume of semen should be 1.5 ml or more. If the volume of semen is low this could potentially indicate that amount of sperm required to fertilise an egg is also low.
Sperm concentration (number of sperm)
The number of sperms we would expect to see for a normal sample would be 15 million spermatozoa per ml or more. Any less than this could indicate an issue with your fertility. Fertility treatments are very effective in treating of infertility due to low sperm count.
This is the assessment of the percentage of sperm with progressive motility (i.e., mobile and moving) and those which display non-progressive motility (i.e., immobile or dead). In a normal sample we would expect 40% or more sperm to be motile, with a minimum of 32% showing good forward movement. Any less than this may highlight an issue or mean there are too few motile sperm to reach the egg and fertilise it.
Morphology (shape & appearance of the sperm)
Normally, sperm are mass produced by the millions and for this reason many of the sperm which are produced within the body are formed incorrectly and carry abnormalities. We expect to see in a normal sample only 4% or more of sperm being of a normal shape and appearance, which we report as those having a normal morphology.
If the semen analysis result is poor some further tests could be recommended:
Sperm DNA fragmentation testing
High levels of sperm DNA fragmentation are associated with reduced natural pregnancy rates and affect 20-30% of men seeking fertility treatment. Sperm DNA fragmentation is also correlated with poor embryo development and a reduction in pregnancy rates following assisted conception (IVF) treatments. The reason for this is because high levels of DNA damage in the sperm can promote the embryo to stop developing, arrest and enter into a pathway of degeneration.
A normal semen analysis does not necessarily mean that the sperm are free from DNA damage. This is because a routine analysis of the sperm cannot evaluate the DNA fragmentation. High levels of DNA fragmentation can be reduced through nutritional (antioxidants) and lifestyle changes and treatments of any underlying infections.