Male infertility is estimated to account for 40% of the fertility issues treated worldwide affecting 1 in every 6 couples. 20% of cases are due solely to male factor and a further 26% are due to a combination of male and female.
Semen analyses give precise information on semen volume, sperm count, sperm motility, sperm morphology (shape), pH and possible investigation of antisperm antibodies
Understanding sperm analysis
Semen has two major quantifiable attributes:
Ejaculation:
About 90% of semen volume is made up of secretions from the prostate and seminal vesicles, with minor contributions from the bulbourethral (Cowper’s) glands and epididymides. .
Semen quality
Sperm concentration is not a direct measure of testicular sperm output, as it is influenced by the functioning of other reproductive organs;. There can be a large biological variation known intra-individual variation in semen composition in semen quality reflecting the many factors listed above, and requires that all measurements on semen be precise.
Ideally the sperm motility should be recorded within 1 hour of collection, and kept between 20 °C and 37 °C during transport.
Volume
The volume of the ejaculate is contributed mainly by the seminal vesicles and prostate gland, with a small amount from the bulbourethral glands and epididymides.
PH of Sperm
The pH of semen reflects the balance between the pH values of the different accessory gland secretions, mainly the alkaline seminal vesicular secretion and the acidic prostatic secretion.
Acid pH and low volume may signify congenital absence of the vas whereas high pH with unusual odour or cellular degradation needs further investigation for infections.
SEMEN DIAGNOSTIC REFERENCE VALUES
The values presented below are referenced against ‘WHO’ criteria and are to be used for guidance purposes only.
The semen reference values will help the clinician decide in an evidence based manner on the patient management since the values have been derived from numerous studies. After 12 months of trying for a pregnancy, a semen analyses is essential.
Cost of Sperm test
A comprehensive sperm test costs £140 at TDL laboratories and the results can be discussed at an appointment with the consultant . Fertilityplus does not offer sperm tests outside a consultation
Semen Analysis Parameters limits are based on reference values derived from the 5th centile;
Parameter Reference Values
Volume (mls) > 1.5ml
Viscosity Normal
pH 7.2-8.1
Sperm concentration (million /ml) 15 million/ml
Sperm per ejaculate (millions) 39 millions
Motility % Progressive
%Total 32 %
40 %
Sperm Morphology (% normal forms) 4 %
Vitality (% live / dead) 58 %
MAR IgG (direct sperm antibody) Neg
Nucleated / round cells millions / ml 1
Leucocytes per (cyturtest) < 25-75
Additional Tests
Some of these tests include: sperm survival tests such as a swim up test, hypo osmotic swelling (HOS) test, vitality tests, post coital tests (PCT), and semen mucus compatibility tests, anti-sperm antibody tests (IgG and IgA), Computer Assisted Sperm Analyses (CASA), Sperm DNA fragmentation tests, sperm selection methods such as ultra-high powered morphologically good sperm.
PCT (Post Coital Test) may be helpful also in some cases of religious restriction to masturbation or in uncovering possible psychosexual problems in couples
When should repeat a sperm test?
Semen tests may need to be repeated as there is individual variability in sperm quality over time and it’s always good practice to perform at least 2 tests over a 3 month period since it takes about 74 days for a full maturation cycle of the human sperm
Mr Gulam Bahadur – Andrologist