Semen Analysis: What To Expect And How To Prepare

The semen evaluation is an important test for couples dealing with infertility. You may have also heard it referred to as a semen analysis, sperm test, or seminogram. In the simplest sense, this test evaluates a man's fertility based on semen quality and sperm count. This is what you should know about a semen analysis, as well as how to prepare for one.

Why do I need a semen analysis?

Infertility issues can arise in the man or woman, or a combination from both. However, a semen evaluation is sometimes the first fertility test a couple will undergo because it's much easier, less invasive, and less expensive than most fertility tests for women.

By narrowing down the list of potential problems that are causing infertility, your doctor can more readily identify treatments that could help you conceive. Additionally, male fertility challenges are often easier to identify and treat. Even so, testing will eventually take place for both partners because in 20% of couples both partners contribute to infertility challenges.

The Fertility Institute of New Orleans regularly performs semen evaluations to help couples overcome infertility. Our team works closely with couples so they have a complete understanding of what to expect and their fertility treatment options.

What does a semen analysis test for?

A semen analysis evaluates more than just sperm motility and count. It also evaluates the quality and quantity of sperm and seminal fluid to detect any issues that can impair the sperm’s ability to migrate up the fallopian tubes or penetrate the egg.

The factors your doctor will test for generally include:

  • Sperm motility: Motility is one of the most important factors in a sperm analysis. This test analyzes the percentage of sperm moving within a sample, as well as the type of movement. At least 50% of the sperm should be motile. Type of movement is graded from Grade 4 (moves rapidly in a straight line) to Grade 1 (no forward progression). Your doctor will discuss your Motility Index, which is calculated with the percentage and grade of your sperm's movement. Typically, unassisted conception is rare with a Motility Index of less than 120.
  • Sperm count (or concentration): This is the number of sperm in each milliliter of fluid. A low sperm count is defined as less than 15 million sperm per milliliter, with at least 39 million sperm per ejaculate. This test may also diagnose certain conditions including oligospermia (less than 15 million sperm/ml), azoospermia (no sperm in ejaculate), aspermia (no ejaculate), or retrograde ejaculation (when sperm flows back into bladder rather than out of penis).
  • Total motile count: The total number of moving sperm in your sample.
  • Volume: The total amount of seminal fluid collected in the sample. Generally, it should be between 2-5ml.
  • Morphology: A measure of the percentage of sperm with a "normal" shape.
  • Viscosity: The thickness of the seminal fluid.
  • Liquefaction time: Semen is typically a thick gel at the time of ejaculation. Within 20 minutes, it generally becomes liquid. This measures the time it takes for the semen to liquefy and can point to potential issues.
  • pH: A measure of the acidity (low pH) or alkalinity (high pH) of your semen, which is normally between 7.4-8.4.
  • White blood cell count: An abundance of white blood cells in semen (called pyospermia) is abnormal and could indicate inflammation or an infection.

How to prepare for a semen analysis

Your fertility specialist will discuss everything you need to know to prepare for your test. Follow their directions and ask your fertility team any questions you have.

Usually, your doctor will ask you to avoid ejaculating for two to five days before your semen analysis. This ensures your sperm count is at its highest. Do not avoid sexual activity for more than one to two weeks before the test, though, because this could result in less active sperm.

For most people, you'll provide a semen sample at your doctor’s office. This will be done through masturbation in a private room, with a sterile specimen cup to collect the sample.

If you're not comfortable with this, your doctor can also provide a special type of condom to collect a semen sample at home. In this case, you will need to deliver the sample to your doctor's office within 60 minutes and keep it as close to body temperature as possible.

Whatever method you choose, you will be given complete instructions by your doctor. Since sperm samples can vary daily, you may need to repeat this procedure multiple times.

Other factors

To ensure the integrity of your results, avoid using lubricants or condoms during your test. In the days leading up to your test, you should also avoid:

  • Alcohol
  • Tobacco
  • Drugs
  • Excessive caffeine
  • Excessive heat (such as in hot tubs or saunas)

Disclose any prescription or herbal medications you're taking as well as these could alter test results.

Next steps after a semen analysis

Once your doctor has evaluated your semen, they may be able to diagnose one or multiple issues that are making conception difficult.

Male fertility treatments may include:

  • In vitro fertilization (IVF)
  • Clearing a blocked vas deferens
  • Correction of a significant variococele
  • Intrauterine insemination (IUI) for samples with low or high volumes, but adequate motility and morphology
  • Treating infections or inflammation
  • A number of other treatments

At The Fertility Institute of New Orleans, we've been making dreams come true since 1976. We know that infertility can be challenging, so we're here every step of the way to help you make sense of your options.

If you're in Louisiana or our neighboring states, we invite you to contact our team to learn more. We're here to help.

 

Originally posted on September 20, 2014.