Semen Testing

Semen testing is one of the most simple and relatively inexpensive approaches to infertility.  Because half of all known infertility causes are linked to male-factor issues, a semen analysis typically is the first step a couple takes through the Fertility Center when beginning to explore assisted reproduction. Volume, count, movement and shape are all examined through semen analyses, which often are considered diagnostic tests and may be covered by insurance.

Semen is the fluid in which sperm are ejaculated. A semen sample must be collected in a sterile specimen container which is available through the Fertility Center offices. The specimen may be collected at home as long as it is delivered to the office within one hour of collection. Please maintain the specimen as close to body temperature as possible during transport since extremes in temperature are detrimental to sperm survival. For those who wish to collect a sample at the Fertility Center, a private gentlemen’s lounge is available. 

It is recommended that men abstain from sex for 2 to 3 days prior to collecting a specimen, but abstaining longer than 4 days may have adverse affects on the quality of the specimen collected. Results from a semen analysis typically are available within 10 days. 

Semen analysis is an evaluation of sperm using two methods. The first step is a basic analysis which tells us how many total sperm are present (for example, 25 million), how many sperm are moving (motility), and how fast they are moving. The second step is a strict criteria morphology which helps determine how many sperm (reported in %) are shaped normally. A normal semen analysis ranges from 20-200 million per milliliter with at least 50 percent moving and 14 out of every 100 shaped appropriately.

Other semen tests may be ordered by your doctor. For example, a sperm hyaluronan binding assay can help determine the ability of sperm to bind to an egg's shell.

Some of the male-factor issues that can be identified include: azoospermia (no sperm), oligospermia (sperm present in low concentrations), asthenospermia (sperm with poor motility or movement) and teratospermia (sperm with poor morphology or shape). Another discovery may be antisperm antibodies produced by the immune system which mistake sperm for an invading substance and begin attacking them, often causing the sperm to clump together, lose motility or lose the ability to fertilize an egg. 

For couples participating in an IVF cycle, information about sperm helps ensure that everything is done at the proper time to help achieve fertilization of the eggs upon retrieval. A semen sample in a sterile container is needed the morning that eggs are retrieved. The specimen can be collected upon arrival at the Fertility Center or collected just prior to leaving home that morning and brought to the office. Another option is to collect and freeze a semen specimen prior to the day of the retrieval procedure, but additional costs may be involved.

Alternate procedures are required to extract sperm from men whose reproductive ducts are blocked as well as from those who have had a vasectomy or have no living sperm in their ejaculate. With assistance from an urologist, our doctors often can collect viable sperm directly from the testes, which store and nourish sperm, through aspiration or testicular biopsy while the patient is under anesthesia. These procedures include percutaneous epididymal sperm aspiration (PESA) and testicular epididymal sperm aspiration (TESA). The microsurgical epididymal sperm aspiration (MESA) procedure is not performed at the Fertility Center since additional specialized equipment is required. In most cases, fertilization can be achieved through intracytoplasmic sperm injection prior to in vitro fertilization, but the quantity of sperm retrieved from an extraction is not sufficient for an intrauterine insemination.