Semen analysis, or sperm count testing, should be part of every couple’s infertility work-up. When compared to the invasive nature of many female infertility tests, semen analysis is easy. Still, it’s common to feel uneasy about any medical testing, and men are often nervous about receiving the results of a semen analysis.
Unfortunately, the sperm count test is often forgotten, especially if a reproductive endocrinologist isn’t evaluating the couple. A sperm count test may not be offered if the woman sees her gynecologist for an infertility evaluation (possibly because gynecologists tend to focus on the woman’s health), and the sperm count test may be overlooked if the woman has already been diagnosed with an infertility problem.
However, making sure to have a sperm count analysis done early on during infertility testing may save you much heartbreak (and dollars) later. Remember -- while one-third of infertility cases involves a problem with just the woman, one-third of infertility cases are a problem with just the man, and another third involve problems on both sides.
For more information on why this test is important, be sure to read this article on the importance of sperm count analysis:
When Can the Test Be Done?
Your doctor will probably tell you that you need to abstain from intercourse for at least two to three days prior to taking the test. According to the American Society of Reproductive Medicine, a semen sample should be taken no less than two to three days after sexual intercourse, and no more than seven days.
The American Society of Reproductive Medicine also recommends that at least two samples are collected, taken about a month apart. So you may need to take the test twice.
Getting the Semen Sample
The semen sample is usually collected by self-stimulation, or masturbation, into a sterile container, but there are also specialized condoms available, allowing a semen sample to be collected during sexual intercourse.
Do not use just any condom, however. Some chemicals in regular condoms can damage the sperm sample, skewing the results. Ask your doctor about how to obtain the specialized condom, and if that method would be better for you.
Also, ask your doctor about lubricant use, as some lubricants are less than friendly to sperm.
Contrary to popular cultural reference, you can often do the test at home, placing the sperm into a sterile container provided by the doctor. However, if you live very far from the fertility clinic, it might be necessary to give the sample at the office. A semen sample should be evaluated within a particular number of hours (within two hours is generally recommended) for best results.
What the Test Measures
A sperm count test looks at the total number of sperm and also how the sperm swim and which direction, and their shape and size. The sperm count analysis also looks at the color of the semen, how it clumps and liquefies, how much semen volume is there, and many other factors.
If a sperm culture is being done, the test may also look for signs of infection.
According to the World Health Organization, a sperm concentration of 20 million per milliliter, and a total of at least 40 million per ejaculate, is needed for optimum fertility. In some cases, however, the number of sperm may be normal, but other factors are less than ideal in the semen, and this is preventing pregnancy achievement.
If abnormal results are obtained, the next step is usually finding out where things are going wrong, and correcting, if possible, the problem or problems. If the problem is not correctable, fertility treatments may be recommended.
Sperm count testing results can be tricky to understand, as there are varying standards. Your sperm count results may fall under “normal” on one scale and “below normal” on another. As always, speak to your doctor if you don’t understand the results of your sperm count test.
Patient’s Fact Sheet: Diagnostic Testing for Male Factor Infertility. American Society of Reproductive Medicine. Accessed May 29, 2008.
A Basic Guide to Male Infertility: How to Find Out What’s Wrong. American Urologic Association. Accessed May 29, 2008.
Patient’s Fact Sheet: Diagnostic Testing for Male Factor Infertility. American Society of Reproductive Medicine. Accessed May 29, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/Testing_Male-Fact.pdf
A Basic Guide to Male Infertility: How to Find Out What’s Wrong. American Urologic Association. Accessed May 29, 2008. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/patient-guides/whatswrongpg.pdf