SEMEN ANALYSIS

The semen analysis is the cornerstone of testing for male infertility problems. This test provides important information about the quality and quantity of the sperm. The semen sample is analyzed for volume, viscosity (thickness), pH and color of the ejaculate, sperm concentration, motility, morphology, and forward progression of the sperm. The sample is also examined for the presence of white or red blood cells which may indicate infection or inflammation. We perform both manual and computer assisted semen analyses (CASA). From this simple test, we can tell how many sperm are present, how many appear normal and how many are moving. A semen analysis does not assess sperm function. It does not answer the question “are the sperm good enough to conceive”. More sophisticated tests of sperm quality such as the Sperm Chromatin Structure Assay (SCSA) can better help asses the “health” of the sperm.

The normal semen parameters established by the World Health Organization are:

Collection Instructions

The semen sample should be collected at the laboratory in a special sterile container after a 2-3 day period of abstinence from ejaculation. Alternatively, the sample may be brought in from home within 1 hour of ejaculation. The sample should be maintained at body temperature which can easily be done by placing the container in a shirt pocket. No lubrication should be used while obtaining the sample as it can be toxic to sperm. Occasionally, due to religious reasons, the sample may have to be obtained during intercourse. A special condom designed for this purpose will be provided.

A minimum of two semen analyses provided several weeks apart, and collected in a similar manner, is recommended because sperm counts tend to fluctuate. We never rely solely on one sperm count.

SPERM DNA FRAGMENTATION ANALYSIS

As mentioned above, testing the sperm for the level of DNA damage can add prognostic information as to how the sperm will perform under various conditions such as natural conception, Intra-uterine Insemination (IUI) and In-Vitro Fertilization (IVF). By combining this information with the parameters of the semen analysis and high density stainability ( a test that looks at sperm chromatin maturity) and the oxidative stress assay (OSA) which measures the levels of toxins in the semen, a much clearer picture of a man’s fertility potential. All these tests allow us to direct a couple into the therapy that may help them conceive the quickest and least expensive/invasive way.