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What is a Semen Analysis Test?

Semen analysis is considered an important test for assessing various andrological diseases, male fertility and assessing the chances of prenancy. The test should have a high level of accuracy so as to achieve an adequate evaluation of all the parameters of male ejaculate.

Semen analysis test is not a fertility test but is the primary test used to evaluate infertility in men. It does not provide any information on the potential of a sperm to fertilise an ovum or undergo processes that will result in an eventual pregnancy. Sperm functional assays along with semen analysis are necessary for further evaluation.

  1. Why is a Semen Analysis test performed?
  2. How do you prepare for a Semen Analysis test?
  3. How is a Semen Analysis test performed?
  4. What do Semen Analysis test results indicate?

There are several reasons why a semen analysis test is performed. Some couples or individuals undergo this test when they experience any difficulty in conceiving. A study has shown that male factor is responsible for infertility in almost 40-50% of the cases. Issues with sperm count and sperm motility as well as sperm morphology (size and shape) can be studied from a semen analysis test to determine the chances of fertilisation.

Semen analysis also helps assess the success of vasectomy. Vasectomy is a procedure conducted for permanent male sterilisation. After a vasectomy, semen analysis is advised by doctors for many months to ensure that there are no more sperms in the semen.

Men are recommended to not be involved in any activity that can lead to ejaculation for 2-3 days prior to the test to ensure an adequate count. The use of any lubricants should be strictly avoided to ensure sperm motility.

A semen sample can be obtained in several ways. Persons can provide a sample through masturbation and ejaculation into a wide-mouthed container at a clinic. If there are any cultural or religious beliefs, a semen sample can be alternatively collected with a special condom used during intercourse. 

A second sample is collected 2 weeks after the first, as sperm counts tend to fluctuate.

Normal results: Normal sperm count ranges between 15 million to 200 million per millimetre of the semen. Normal morphology and sufficient forward motility should be seen in 60% of the sperms. Normal values vary slightly among laboratories. Speak with a healthcare provider or a specialist for proper diagnosis.

Abnormal results: Male fertility issues could be present if the results are abnormal. A sperm count lower than 15 million per millimetre is considered irregular and is usually associated with difficulties in conceiving. Some men may have azoospermia in which the semen is devoid of sperms. Sperms with abnormal size and shape have difficulty in movement, penetration and fertilisation of the ovum.

Other factors considered in a semen analysis are as follows: 

  • Volume: Normal quantity collected should be at least a teaspoon. A volume lesser than one teaspoon suggests an obstruction in the vessels through which semen flows.
  • Viscosity and consistency: It is defined as the rate at which semen liquifies. The semen released from body is thick. Time needed for the semen to liquefy is considered an evaluating factor. Failure or delay in liquefaction indicates irregularity. The desired viscosity should be +1 on a scale of +1 to +4.
  • pH level: The normal pH of semen is between 7.2 to 8.0, which means it is alkaline in nature. If semen is extremely alkaline or acidic, it affects sperm health and its ability to travel and survive in the female reproductive tract.
  • Sperm count: Both motile and nonmotile sperms are counted. Live, swimming sperms are motile sperms, and an ejaculate should contain at least 50% of motile sperms. (Read more: Low sperm count causes)
  • Fructose levels: Low fructose levels in the semen sample is indicative of issues in the seminal glands’ function.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational perspective and is in no way a substitute for medical advice from a qualified doctor.

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Semen Fructose

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References

  1. Vasan SS. Semen analysis and sperm function tests: How much to test?. Indian journal of urology: IJU: journal of the Urological Society of India. 2011 Jan;27(1):41.
  2. Niederberger CS. Male infertility. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 24.
  3. Barak S, Baker HWG. Clinical Management of Male Infertility. [Updated 2016 Feb 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.
  4. Menkveld R. Clinical significance of the low normal sperm morphology value as proposed in the fifth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Asian journal of andrology. 2010 Jan;12(1):47.
  5. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Semen Analysis
  6. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2011, Pp 406-407.