INTEGRIS Bennett Fertility



3433 NW 56th
Bldg. B, Suite 200
Oklahoma City, OK 73112

Semen Analysis

Since male factors are responsible for approximately 30 percent of infertility, the semen analysis is one of the earliest tests in the infertility work-up. The semen sample is usually obtained by masturbation, preferably at a facility near the laboratory.

The most important parameters checked are sperm count, motility, morphology, and the presence of inflammation cells. Sperm count, expressed as millions per cubic millimeter, should be over 20 million. Motility, or the percentage of forward-moving sperm out of the total sperm population, should be above 50 percent. Morphology, or sperm shape, is a very important criterion that best correlates with the ability of sperm to penetrate the egg. Under strict morphology criteria (called Kruger’s criteria), at least five percent of the sperm or more should be of normal shape. Inflammation of cells often indicate prostate or epididymal infection. They reduce the effectiveness of sperm. Inflammation should be treated, usually with antibiotics.

Understanding Your Semen Analysis

DISCLAIMER: This discussion is intended to educate patients and health care professionals about semen analysis results bur is nor a substitute for a consultation with a physician about the appropriate evaluation and treatment of maleĀ­ factor infertility.

The semen analysis is merely a "snapshot" of male reproductive status, much like assessing the weather on a certain day by looking out the window. Excellent results on a semen analysis may predict normal male fertility at that point in time but does not guarantee male fertility a few years from now. Similarly, poor semen analysis results may not indicate poor male fertility forever. Multiple behavioral, medical, and environmental factors may interfere with sperm

Since sperm is produced every 85 days, removal of factors that negatively affect sperm performance may take at least that long to allow an improvement on the semen analysis. Similarly, if the male is exposed to harmful factors, it may cake almost 3 months to see deterioration of sperm performance.

The American Society for Reproductive Medicine (ASRM), in a 2012 publication (Fertility and Sterility 98(2)294-301, 2012), determined the lower limits of the accepted reference values for a semen analysis:

  • Sperm Concentration (count) >15 million per ml
  • Sperm motility > 40%
  • Sperm strict morphology (shape) > 4%

Other factors of importance are volume of ejaculate, pH (acidity), the presence of sperm agglutination ("sticking together"), viscosity (thickness of fluid), and the presence of white blood cells (indicating infection or inflammation).

If one or more of the parameters above are abnormal (lower than above), attention should be paid to the presence of male factor infertility and investigative and possibly therapeutic action should be initiated. This includes counseling and education regarding factors that can be harmful for sperm performance, and possible evaluation and treatment by a urologist. While at lease half of cases of sperm problems are unexplained, some of the common factors reducing sperm performance are as follows:

  • Excess heat (frequent use of hoc cub, heavy clothing with pro longed sitting)
  • Testosterone use
  • Extreme stress
  • Medical illness(e.g. diabetes)
  • Infections (sexually-transmitted diseases, prostate infections, urinary trace infect ions)
  • Environment al toxins (heavy metals, paint products, herbicides, pesticides)
  • Marijuana, heavy smoking, heavy tobacco chewing, heavy drinking
  • Genetic causes (e.g. Y-chromosome abnormalities)
  • Varicocele (dilated veins in the scrotum)
  • Hormone abnormalities(e.g. thyroid and prolactin problems)

What should I do if my semen analysis results are abnormal?

Repeat the semen analysis in 2-3 months (especially if certain lifestyles are identified as a possible cause, e.g. especially testosterone use, and can be changed in the inter im).
Consult with your physician about your results and about possible referral to a urologist or a reproductive specialist.
Read about male factor infertility (e.g. Fertility and Sterility 98(2):294-301,August 2012 ) and educate yourself. Learn to identify environmental and lifestyle changes that may be beneficial for sperm performance.

Please remember that Bennett Fert ility Institute (BFI) at INTEGRIS is a testing facility bu t cannot provide you with interpretation of your test results unless you make an appointment with one of its affiliated physicians (Dr. Kallenberger and Dr. Reshef at 405-94 5-4701). The physician who ordered the test should be the first one to contact regarding results and further referral.