What Is Semen Analysis? Know About Normal And Abnormal Results
Infertility can be a troubling issue for many individuals. It can also be a frustrating experience as many people do not fully understand the concept of infertility or why they are affected. It is vital for us to understand that the reason behind infertility can be either male or female, or even both.
The examination by a fertility specialist is the only way to pinpoint the exact cause and work towards a solution. While a woman might be asked to undergo various screening, depending on various factors, for men, semen analysis is one of the most common tests to determine the cause of infertility.
About one-third of the cases affect women, one-third of the cases points out the problem with men while the other one-third cases are either from both sides or unexplained.
Semen analysis is used to assess not only the sperm count but much more than that including quality and health of sperm. The test is an important part of couple’s infertility workup. A semen analysis basically covers following aspects of sperm health:
- Sperm count
- Shape of the sperm
- Movement of the sperm or sperm motility
- Total volume of ejaculation
- Color of the semen
- The pH of semen (to know how acidic it is)
- White blood cells in semen (that indicates an infection)
- Sperm viability (how many sperms are alive)
Semen Analysis in India
Though the female infertility diagnostics in India is at par with the global level, when it comes to male infertility diagnostics, the situation is miserable. This is due to lack of following the guidelines given by WHO which includes semen viscosity, motility, concentration, pH and morphology.
Secondly, as sperm is a fragile bodily fluid, it has to be examined within an hour after collection. But due to lack of trained technicians and proper instrumentation, India is failing to comply with the international standards of semen diagnosis.
The picture is much more dismal. Experts say that incorrect diagnosis is the reason why many couples are increasingly opting for in-vitro fertilization.
Preparing for Semen Analysis
Your doctor will guide you through all the procedure. You can expect following instructions from his side:
- Abstain from sexual intercourse or ejaculation at least 2 to 3 days before the test
- Abstain from caffeine and alcohol 2 to 5 days prior to test
- Avoid any sort of hormone medication as prescribed by your doctor
Discuss with the doctor in detail about the current medication before going for the test.
How the semen test conducted?
The sample is usually collected by self-stimulation of the penis and dropped into a sterile container. There are four methods to collect semen:
- Through masturbation
- Having sexual intercourse but withdrawing before ejaculation. Also known as coitus interruptus
- Sex with a condom
- Electric stimulation to ejaculate semen
The semen can be collected at home but must be delivered to the testing clinic within 30-60 minutes of leaving the body. Many clinics or diagnostic centers have a separate room for semen collection. It might cause uneasiness in men as they tend to become nervous in providing a semen sample, though it’s completely normal to have this kind of feeling.
What are normal test results?
After the collection of the semen, you can know the results within 24 hours or it may take a week, depending on the testing facility. A doctor takes into account several factors. You might get ‘normal’ result in one or more but ‘abnormal’ results in others. We will elaborate them below:
Shape of the sperm
The lab test checks sperm head, midsection and tail. If shape of more than 50 percent of sperm is found normal, then the test is negative, otherwise this indicates fertility issue.
Movement or Motility
The movement or motility of sperm indicates the capability of traveling to the egg for fertilization. In this respect, over 50 percent sperm should be moving normally after ejaculation. The test analyses the movement of the sperm and rates them on a scale of 0-4. A rating of zero means no movement while 3 or 4 show healthy movement.
Also known as sperm density, the sperm count test should show number between 20 million to above 200 million. If the number is below 20 million, this can make conception more difficult.
The normal semen volume in the test should be more than 2 millilitres. If it is low, then the sperm volume could also be low or not enough to fertilize an egg. The excess semen volume could also mean the sperms are weak.
The pH level indicates the acidity or alkalinity of the semen. It should be between 7.2 and 7.8. Higher than 8.0 suggests an infection while less than 7.0 indicates that the ejaculatory ducts are blocked.
Normal semen is thick and it liquefies within 15-30 minutes. This liquefaction helps the sperm in good movement. If semen doesn’t liquefy within 15-30 minutes, it would affect fertility.
Color or Appearance
Normal semen is whitish to gray in color. If the shade is red-brown, it indicates presence of blood while if the semen has yellowish tint, it could be due to jaundice or any medication side effect.
Fructose is the major source of energy for the sperm. High level of fructose indicates good health of sperm, while low concentration of fructose means the vas deferens are obstructed.
What if the results are abnormal?
One test might not necessarily indicate a problem. You can also go for another test. If again the test shows the same results, then your doctor might recommend some additional tests. He may recommend medicines to treat the condition, changes in lifestyle, or might suggest going for fertility treatments.
Sometimes semen analysis could be tricky to understand. So it’s always better to have a word with the doctor. You must also discuss with him any concern regarding the test. Men tend to be hesitant about the testing due to fear of questioning their manhood or embarrassment regarding the procedure.
Remember, even if fertility problem has been identified in one partner, that does not mean the fertility of other partner is normal. Both the partners should be tested in case of infertility.