Male factor infertility is not uncommon. Approximately one-third of the cases of infertility involve dysfunction of the male reproductive system and one-third of the cases of infertility involve dysfunction of the female reproductive system. Many couples have both male and female factors affecting their ability to achieve pregnancy. One of the most frustrating and difficult diagnosis to accept is unexplained infertility. When the cause of a couple’s infertility cannot be determined, or no cause can be found, it is determined to be unexplained infertility. When a patient is unable to achieve pregnancy, testing must be performed in order to determine the cause of the fertility issue. For men, the first step in fertility testing is sperm analysis (semen analysis).
Diagnosing Male Factor Infertility using Sperm Analysis
At the Centre for Reproductive Medicine in Lubbock, it is strongly recommended that male patients undergo semen analysis to determine if male factor infertility is contributing to the couple’s inability to conceive. The results of the semen analysis will determine if further testing is necessary. A semen analysis may also be used to determine if a vasectomy reversal procedure was successful.
The sample for the semen analysis is typically obtained by the patient ejaculating into a sterile cup. In order to better ensure that the results are accurate, patients may be advised to refrain from ejaculating for two to five prior to the semen analysis. While patients should refrain from ejaculating for a few days before the semen analysis, prolonged inactivity may result in sperm being less active than normal. Patients may also be advised to avoid consuming alcohol for three to five days prior to the semen analysis.
Once the sample has been obtained, it is sent to a laboratory where a number of tests may be performed, including:
- Sperm motility: This test is performed to measure the percentage of sperm, and the number and quality of the sperm that move normally.
- Sperm morphology: This test is performed in order to measure the percentage of sperm that have a normal shape. In a normal result, at least 30 percent of the cells have a normal shape
- Volume: An abnormally low result can indicate that there may be issues with the seminal vesicles. The seminal vesicles may be blocked or may not be making an adequate amount of fluid. An abnormally low result may also indicate that there is a problem with the prostate gland.
- Acidity or ph levels: This test may be performed to measure the ph levels of the semen.
- Sperm count: This test is performed to determine the number of sperm present per milliliter of semen. A normal range for the number of sperm per milliliter is between 40 million to 300 million. A poor sperm count is 10 million or below. A count of 20 million, while not in the normal range, may be adequate if there are no issues found with the morphology and motility of the sperm.
- Liquefaction time: At the time of ejaculation, normal semen is liquid that immediately coagulates into a white gel. This gel becomes liquid within twenty minutes of ejaculation. If the semen does not coagulate or liquefy there may be a problem with the seminal vesicles.
- Seminal fructose levels: The seminal vesicles normally produce seminal fructose. The absence of seminal fructose may indicate a congenital absence of the vas deferens or seminal vesicles. It may also indicate an obstruction of the ejaculatory duct.
Depending upon the results of the semen analysis, a couple’s infertility treatment plan may change. While male factor infertility can greatly impact a couple’s chances of conceiving, many patients have found success through IVF. To learn more about fertility testing and treatment, please contact the Centre for Reproductive Medicine today.