Semen analysis evaluates certain characteristics of a male’s semen and number of semen contained.The most common reason for this investigation in the laboratory is to determine couples infertility or for sperm donation .The most common way to collect a semen sample is through masturbation, directing the sample into a clean cup or during intercourse in a special type of condom known as a collection condom or through coitus interruptus ( withdrawal) .
Parameters measured in semen analysis are: sperm count, motility, morphology, volume, ph, fructose level. Sperm count measures the concentration of sperm in a man’s ejaculate, over 15 million sperm per milliliter is considered according to the WHO in 2010.
Motility: Semen must be analysed within 60 minutes of collection. Motility of sperm is divided into four different grades.
- Grade A: Sperm with progressive motility. These are the strongest and swim fast in a straight line.
- Grade B: Non linear motility. They move forward but tend to travel in a curved motion.
- Grade C: These have non-progressive motility because they do not move forward despite the move that they their tails.
- Grade D: These are immotile and fail to move at all.
Morphology: All spermatozoa that have observable defects are disadvantaged in terms of fertilizing an Oocyte (egg).
Volume: WHO regards 1.5ml as the lower reference, in clinical practice, a volume of less than 2ml in the setting of infertility and absent of sperm should prompt an evaluation for obstructive azoospermia.
Fructose level: WHO specifies a normal level of 13µmol per sample Absence of fructose may indicate a problem with the seminal vesicles.
PH: WHO criteria specify normal as 7.2- 7.8. Acidic ejaculate (lower ph value) may indicate one or both of the seminal vesicles are blocked, A basic ejaculate (higher ph value) may indicate infection.
Liquefaction: This is a process where the gel formed by proteins from the seminal vesicles is broken up and the semen becomes more liquid, it normally takes less than 20 minutes for the sample to change from a thick gel into liquid.
Testing and diagnosis involves the semen analysis, general physical examination and medical history of the patient. Sperm counts often fluctuate, most semen analysis are done over a period of time to ensure accurate results. Improper collection of the sperm sample may affect the count, therefore doctors are expected to check two or more semen samples overtime to ensure consistency between samples .New sperm are produced continually in the testicles taking about 60-80days to mature.
Lubricant must be avoided because they are harmful to sperm, the collection of the semen should be in a familiar environment.
RESULT: Normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen .You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate.
Other test depending on your physician’s findings and possible cause includes: post-ejaculation urinalysis Hormonal testing, genetic tests, antisperm antibody tests and transrectal ultra sound.