The Importance of Male Infertility Evaluations
Approximately 40%-50% of infertility is male factor related.
To assess for male factor infertility, we perform a semen analysis. This is a simple, in-office analysis that does not require any commitment to treatment.
A semen analysis looks for abnormalities in sperm count, motility, and morphology. A full list of characteristics we test is included below.
If low sperm count or a high percentage of sperm abnormalities is found, further testing may be done. This can include measuring hormones such as testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), or prolactin. If sperm count or motility is extremely low, a small sample (biopsy) of the testicles will be used for further evaluation.
Certain conditions may be linked with a low or absent sperm count. These conditions include orchitis, varicocele, Klinefelter syndrome, radiation treatment to the testicles, or diseases that can cause shrinking (atrophy) of the testicles (such as mumps).
What Is A semen analysis?
This is a measure of how much semen is present in one ejaculation.
- Normal: 2-5 milliliters (mL) (0.002-0.005 L in SI units) per ejaculation
- Abnormal: An abnormally low or high semen volume is present, which may sometimes cause fertility problems.
Sperm movement (motility)
This is a measure of the percentage of sperm that can move forward normally. The number of sperm that show normal forward movement in a certain amount of semen can also be measured (motile density).
- Normal: More than 50% of the sperm show normal forward movement after 1 hour.
- Abnormal: Sperm must be able to move forward (or “swim”) through cervical mucus to reach an egg. A high percentage of sperm that cannot swim properly may impair a man’s ability to father a child.
This is a measure of the acidity (low pH) or alkalinity (high pH) of the semen.
- Normal: Semen pH of 7.1-8.0
- Abnormal: An abnormally high or low semen pH can kill sperm or affect their ability to move or to penetrate an egg.
White blood cells
White blood cells are not normally present in semen.
- Normal: No white blood cells or bacteria are detected.
- Abnormal: Bacteria or a large number of white blood cells are present, which may indicate an infection.
Semen is a thick gel at the time of ejaculation and normally becomes liquid within 20 minutes after ejaculation. Liquefaction time is a measure of the time it takes for the semen to liquefy.
- Normal: 20-30 minutes after collection.
- Abnormal: 20-30 minutes after collection.
This is a count of the number of sperm present per milliliter (mL) of semen in one ejaculation.
- Normal: 20 million spermatozoa per milliliter (mL) or more
0 sperm per milliliter if the man has had a vasectomy.
- Abnormal: A very low sperm count is present, which may indicate infertility. But a low sperm count does not always mean that a man cannot father a child. Men with sperm counts below 1 million have fathered children.
Sperm shape (morphology)
This is a measure of the percentage of sperm that have a normal shape.
- Normal: More than 30% of the sperm have normal shape. Kruger criteria: More than 14% of the sperm have a normal shape.
- Abnormal: Sperm can be abnormal in several ways, such as having two heads or two tails, a short tail, a tiny head (pinhead), or a round (rather than oval) head. Abnormal sperm may be unable to move normally or to penetrate an egg. Some abnormal sperm are usually found in every normal semen sample. But a high percentage of abnormal sperm may make it more difficult for a man to father a child.