Male Factor Infertility Testing; Sperm Tests
Semen Analysis and Male Fertility Treatment for Pregnancy
Nov 1, 2009
Many factors affect male fertility; fortunately it’s easy to test for problems by a simple male infertility test called a semen analysis. All that’s needed is a fresh semen specimen and a good lab. There are even do-it-yourself simple screening tests for semen analysis that can be done at home, but they test only the basics. A fertility specialist is the best person to do a semen analysis.
What Semen Analysis Shows About Sperm Count and Motility
Semen analysis is the most basic male infertility test. Sperm counts and sperm motility can only be seen under a high powered microscope, and must be studies no more than 15-20 minutes after ejaculation to be accurate.
Semen analysis shows that a number of factors can relate to male factor infertility. One of the most important is the sperm count, which should be at least 20 million sperm per ml; less than 20 million per ml. is considered a low sperm count, or oligospermia. No sperm at all is called azoospermia. Sperm motility is also important. More than 40 percent of sperm in a semen analysis should be motile, or moving. On a scale of 1-4, at least 2+ should be moving forward.
Sperm morphology means that the sperm are normally shaped, have only one head of normal size, and one tail. According to World Health Organization (WHO) book, WHO Manual for the Standardized Investigation, Diagnosis and Management of the Infertile Male published by Cambridge University Press, criteria for evaluating semen analysis for male factor infertility should be that at least 30 percent of sperm should be considered normal. If a fertility specialist uses strict Kruger criteria, which has a much narrower definition of a normal sperm, at least 14 percent of sperm should be considered normal.
Semen viscosity may be tested; semen should gel quickly but liquefy within 30 minutes. Some other male factors that may be tested in semen analysis are testing for anti-sperm antibodies; no anti-sperm antibodies should be present.
Causes of Low Sperm Count and Motility
Many male factors affect fertility. These can be broken down into a few categories most commonly seen in male factor infertility.
Diseases that affect male fertility include:
- Diabetes
- History of testicular cancer and chemotherapy
- Hormone imbalances
- Kidney disease
- Sickle cell disease
Some lifestyle causes of male factor infertility include:
- Anabolic steroids. Suppress testosterone and severely decrease sperm counts.
- Chemical exposure. Work with chemical compounds can increase the number of abnormal sperm and decrease sperm counts.
- Marijuana use. Can result in decreased sperm production.
- Smoking. Can decrease sperm count and increase the number of abnormal sperm in a sample.
Anatomical causes of male factor infertility include:
- Absence of the vas deferens. The vas deferens is the tube that delivers sperm to the ejaculatory duct.
- Kleinfelter’s Syndrome. A man with Kleinfelter’s has XXY karyotype rather than XY.
- Sertoli Only Syndrome. Congenital absence of the cells that produce sperm.
- Varicoceles, abnormally dilated spermatic veins. Can result in decreased sperm count.
Treatment for Male Infertility
Male factor infertility can be treated. A low sperm count or poor sperm morphology can be treated through Intra Uterine Insemination (IUI), where sperm are concentrated after being “washed" so that the best sperm are used for fertilization, or by intracytoplasmic sperm injection (ICSI), where one sperm is injected directly into each egg after egg retrieval during in Vitro fertilization(IVF).
For less severe problems, lifestyle changes may be the only changes needed for treatment of male infertility. Stopping harmful practices like drinking alcohol, smoking, and starting fertility friendly practices like wearing loose underwear and not holding a hot laptop directly on a lap (two things that raise testes temperatures, which can damage sperm) can help increase borderline sperm counts.
Anyone with male factor infertility should be receiving treatment for male infertility from a fertility specialist. Treatment for male infertility can help even some of the most serious male fertility issues, through sperm aspiration directly from the testes at the time of an IVF procedure.
There’s Hope With Male Infertility Factors
Male factors such as low or no sperm count aren’t hopeless. There are more treatment for male factor infertility today than there ever have been before. Find a good fertility specialist, follow their recommendations, and chances are, pregnancy will occur in time and with treatment.
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