Why would you be doing a Semen Analysis (SA)?
Since male factor accounts for about 35% of infertility, a RE’s office
will administer a SA as one of the first tests they’ll do to diagnose
you as a couple.
A SA measures the following:
Volume (measured in mL)
Liquefaction time
Sperm count (both the overall count and per mL)
Sperm motility (the percentage of sperm that are moving – these
are your “swimmers”). Most clinics also measure how many sperm
are moving forward, which is called the “forward motility” test.
Morphology (the percentage of sperm that have a normal shape).
The SA also measures the pH balance, number of white blood cells, and
amount of fructose in the sample.
What you can expect
Giving a sample
Generally, clinics require that you to not ejaculate for 48 hours before
the test, BUT also do not abstain for more than 72 hours. In layman’s
terms: they want you to ejaculate once between 2 and 3 days before the
SA, but then abstain until after the SA.
Obviously, this is not a painful process, but it can be embarrassing.
I have heard stories where someone’s husband had to use a bathroom
off the waiting area to produce his sample – the poor guy! In most
clinics, especially the bigger ones, though, they have a room set up with
magazines (and even movies) for you to do his thing. And in most cases
they’ll let the wife go in with him if he so desires.
Some clinics also allow for the sample to be produced at home if you live
close to your clinic. Once the sample is produced, though, you need to
keep it warm and get it to the clinic within 1 hour, or some of the sperm
begin to die off.
Results
Generally you’ll get the results back within a couple of days of
the SA, but it depends on your clinic. We got our SA results the following day.
Normal parameters of sperm are the following (*Based on World Heath Organization criteria, 1992. Table excerpted from Berger, G.S., Goldstein, M., and Fuerst, M. (1995). The Couple’s Guide to Fertility. New York: Doubleday):
Normal Ranges for a Semen Analysis*
Liquify?: Yes – within one hour
pH: 7.5 to 8.1
% Motility: Greater than or equal to 50%
% of 3-4 + Forward Motile Sperm: Greater than or equal to 50%
Sperm Concentration: 20-200 million per mL
Total Sperm Count: Greater than or equal to 40 million
Total Motile Sperm: Greater than or equal to 20 million per mL
White Blood Cells: Less than or equal to 1 million per mL
% Normal Morphology: Greater than or equal to 30%
Problems that might arise
There aren’t many problems that will present themselves in terms
of the collection process, unless you miss the cup or can’t ejaculate.
If the results come back abnormal, your RE will suggest that you see a
urologist, who can provide a further diagnosis. Additionally, at times,
you can bypass sperm issues by trying IUI or even IVF with ICSI to get
pregnant. I have also heard from my RE that there are other nifty high-tech
sperm extraction procedures that can give you a chance of getting pregnant
– even if your husband has a zero sperm count. At the same time,
there will be men who will need to use donor insemination if this is your
diagnoses.