Understanding your semen analysis report

Semen analysis is the baseline test for assessing the male partner when couples present with subfertility/infertility issues.  In couples presenting with fertility issues, in about a third (30%) of couples, subfertility/infertility is because of a low sperm count or problem in the male.

In another 25%, there are fertility issues in both the male and female partners contributing to infertility. Hence in approximately 50% of the couples, there is a cause in the male contributing to the infertility problem.

Many couples are not aware of this and hence it is important to assess both the male and female partners when couples present with subfertility/infertility issues so that the problem is identified and focussed  treatment can be directed towards the problem.

You can determine your sperm count through a semen analysis which can be done at a fertility clinic for more accurate results. If the semen analysis shows abnormalities, then one additional test after a time interval of 2-3 weeks helps in getting an accurate analysis.

Understanding your semen analysis

A semen analysis tests for the following:

• Number of sperm (Sperm count)
• Shape of sperm (Morphology)
• Movement of sperm, or “sperm motility”
• The number, shape, and motility of sperm are important for testing for male factor infertility.

Semen analysis results table

World Health Organization (WHO) results below show how a normal semen analysis result look. Since results can vary from person to person, the below results show a range which is considered normal.

WHO reference range

The semen analysis may reveal the following figures:

Normal sperm count: 15 million sperm up to >200 million sperm per milliliter (mL) of semen.

Low sperm count (oligospermia): < 15 million sperm per milliliter, or < 39 million sperm per ejaculate.

High sperm count: > 200 million sperm per millimeter.

How does sperm count affect fertility?

Low sperm count definitely decreases the chances of getting your partner pregnant. In addition, if there is are problems with motility of sperm, this too can affect the chances of conception.

In 30% of the infertility cases, the reason could be identified as male infertility factor. While there are several options to help the couple conceive, one must also check the couple for other health issues. It is important to check for female fertility issues also as subfertility is a couple issue.

The doctor will also check for female infertility factors including ovulation problems, Low ovarian reserve, Blocked fallopian tube and Endometriosis.

Sometimes there a tendency of impatience among couples and not being able to conceive could be simply identified to the fact that they haven’t tried long enough. Even if the couple do not have any fertility issues, it can take upto six months to a year to get pregnant.

If you are above 35 years of age and have been trying to conceive for six months, you may have to see a fertility specialist. If you have been trying to conceive for more than one year, and both the partners are under 35 years of age, then you should see a fertility specialist.

Here are some of the most common causes that could be related directly to infertility in men:

• Lifestyle issues such as smoking, alcohol, stress, and obesity can all have a negative influence on the sperm count.
• Hormonal imbalances too can be a cause of infertility in men.
• Tubal blockage – spermatic cord is a tube-like structure which carry sperm from the testis and their blockage could cause infertility. These blockages could be a result of – an infection-either a sexually transmitted infection or tuberculosis, surgery or a genetic/inherited condition.
• Some infections can be of such nature that it might affect the sperm production or sperm health. It can also block the passage of sperm or cause scarring. These infections could cause inflammation of the epididymis or some sexually transmitted infections, including gonorrhoea or HIV.
• Congenital (Genetic) causes such as Klinefelter’s syndrome (chromosomal abnormality) or genetic conditions related to deletion of genes from Y chromosome (male chromosome) may also give rise to male infertility.
• Long-term use of steroids or chemo/radiation treatments for cancer can cause impairment of sperm production leading to sub-fertility.

Are there treatments for low sperm count?

The following factors may influence low sperm count:

• Past surgeries
• General health
• Sexually transmitted diseases

However in most instances the cause of low sperm count is not known (upto 80%) called idiopathic in medical terms and in these men specific treatments such as IUI or IVF is the way forward based on the sperm count.

In case there are problems related to sexual intercourse like premature ejaculation or erectile dysfunction, medication combined with counseling will be recommended.

• In case the patient has a varicocele (dilated veins in the scrotum)-in  severe grade associated with pain the way forward is to get it corrected or repaired surgically. However the vast majority have only mild varicocele and in these men correction of varicocele does not increase the sperm count.
• Sometimes it is possible that a bacterial infection may be affecting the sperm count or fertility, for which antibiotics may be prescribed.

In cases where there is influence of  low hormone levels, there are hormone treatments and medications.

In some cases  lifestyle choices can also play a role and the following actions can improve the sperm count in addition to overall health:

• Obesity or being overweight can affect the sperm count and it would help if the patient maintains a healthy lifestyle through diet and exercise.
• Sometimes it is possible that there are certain deficiencies, which can be revealed through a blood test. The solution would require the patient to include new foods or taking supplements to help restore vitamin and mineral levels.
• It is a well known fact that substance abuse needs to be avoided at all costs if you are serious about conceiving which includes heavy drinking and drug or tobacco use.
• Patients with low sperm count, need to see a fertility specialist, and depending on the case discuss the various treatment options.

At Mother-To-Be fertility clinic we offer various treatment options for patients with low sperm count:

Intrauterine Insemination (IUI)

In vitro fertilization (IVF)

IVF with intracytoplasmic sperm injection (ICSI)/IMSI

Talk to a fertility expert about your concerns and options and get an appointment here: https://mothertobe.in/appointmen/

Frequently Asked Questions on Semen analysis

Is there a medicine for a low sperm count?

How to check the fertility of sperm?

What is good to increase sperm volume, motility and count?

What are some facts about male fertility?

How do male fertility tests work?

How can one know that one’s sperm is healthy for reproduction?

What effect does diet have on male fertility?

How to read a sperm test result?

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