Washington Center for Reproductive Medicine

Male Infertility- The Semen Analysis

The semen analysis is one of the most important fertility tests. Studies show that approximately half of couples with infertility have a male factor infertility component. Andrology is the study of sperm and their characteristics and an andrologist specializes in sperm analyses. Most reproductive laboratories have an andrologist on staff andshould perform the semen analysis.

Collecting Sperm

When collecting a semen specimen for analysis, sexual abstinence should be practiced for at least three days, but not more than five, before collection unless instructed otherwise by the physician. Because of the need to maintain specimen integrity, collection at our lab facility is suggested.

The preferred method of collection is masturbation, using a provided sterile glass container. Lubricants, hand cream, or lotions contain toxic and spermicidal agents, as does K-Y Jelly, and should not be used. Saliva can introduce normal oral bacteria into the specimen, which can damage sperm. Even plain water can kill sperm.

The Andrology Laboratory

A laboratory experienced in reproductive analysis, employing the Kruger strict criteria, should conduct the semen analysis. Our laboratory conducts hundreds of semen analyses each year. The semen is expertly examined for:

  • Volume (amount of fluid that makes up the semen, usually expressed in milliliters)
  • Sperm count (number of sperm in a standard given volume)
  • Motility (percent of sperm that are moving when the semen is examined under the microscope).
  • Progression (forward movement of sperm cells)
  • Viability (percent of sperm that are shown to be alive by use of a special staining technique)
  • Sperm morphology (shape) and additional semen contents, such as white blood cells (which can indicate the presence of infection)

A normal semen specimen has the following parameters:

  • More than 20 million sperm per milliliter
  • More than 50% actively motile
  • More than 14% highly normal forms suggesting excellent fertilizing capacity
  • Less than five white blood cells per high power microscopic field

During sperm development (spermatogenesis), normally and abnormally shaped sperm are produced. Until recently a normal sperm sample was deemed to have no more than 50% abnormal sperm.

By using very strict criteria (Kruger Criteria) to evaluate sperm quantity and morphology (shape), we can predict the fertilizing capacity of sperm. It has been demonstrated in the IVF model, that if more than 14 % of the sperm sample are normal, fertilization rates can be excellent.

Environmental Factors Affecting Sperm Quality

Spermatozoa are relatively fragile cells and are easily damaged by a number of environmental and life style habits. Increased temperature resulting from illness, sitting in hot tubs, and saunas, or wearing tight clothing can affect sperm production and function leading to male infertility. Strenuous exercise, such a long distance bicycling or marathon running, can also have damaging effects, as can recent significant weight loss or gain.

Drugs (including alcohol and nicotine) are proven to decrease male fertility and should be minimized or avoided while attempting to achieve pregnancy.

Men with poor semen analyses can often father children through the use of intracytoplasmic sperm injection (ICSI) combined with IVF. In cases where an adequate number of sperm can be collected, intrauterine insemination (IUI) is sometimes the therapy of first choice.


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