Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV
If you have infertility and you see your doctor... one of the first tests that he or she is likely to recommend is a semen analysis. The semen analysis is designed to make sure that a male has sperm and to try to predict what the likelihood is of sperm reaching the Fallopian tubes where fertilization happens.
There are several components to a semen analysis. Reading a semen analysis report can be confusing. Today on infertility TV we will explain a semen analysis report.
Volume
This tells you how much seminal fluid comes out in the ejaculate. By itself this is not a very helpful number for predicting fertility. The main reason why men may have a low semen volume is that they spilled some when trying to collect the specimen. Higher volumes are not associated with a better chance for getting pregnant.
Concentration
This is the most important number in the semen analysis. It tells you how many sperm there are. Men with very low sperm numbers definitely have more difficulty in achieving a pregnancy a normal sperm concentration is 20 million per milliliter however men with lower numbers may still be able to achieve a pregnancy or even have normal fertility. Higher numbers do not mean a better chance for getting pregnant.
Motility
Motility is a measurement of the movement of sperm. sperm have tails which whip back and forth very quickly to propel the sperm forward in the female reproductive tract. Some sperm may not move at all. Some sperm may move slowly or ineffectively. The net result is that less sperm will reach the fallopian tube and therefore the chance for fertilizing an egg is lower. The most important motility number is called Progressive motility. This is the percentage of sperm that have fast forward movement. These sperm are the ones most likely to reach the fallopian tube.
Morphology
This is a an estimate of the percentage of sperm with a normal appearance under the microscope. This is perhaps one of the most confusing parts of the semen analysis. This is due in part to the fact that there are different criteria for assessing morphology with different estimates for what is considered normal. These days most fertility specialists will use a criteria called strict morphology also known as the Kruger morphology after the physician who came up with it.
All men even those with normal fertility will have some percentage of sperm with an abnormal appearance under the microscope. However men that have a very high percentage of abnormal appearing sperm have more difficulty producing pregnancies and their partners. It is not known precisely why their pregnancy rates are lower.
There are two ways in which physicians might use these measurements. In some cases, the doctor may look at a specific number like motility and if it is abnormal, make certain recommendations for further testing or treatment. In other cases, doctors may calculate the total number of normal moving sperm by multiplying the volume times the concentration times the percent motility times the percent normal morphology. And if that falls below a certain number then those men are determined to be subfertile.
Keep in mind that there is a tremendous amount of variability in these numbers. Any abnormal result on a semen analysis should be repeated to see if it is persistent or not.
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