Male Fertility and Semen Analysis

What does a semen analysis check?

There are 3 main things that a semen analysis checks:

• Sperm count
• Sperm motility (movement)
• Sperm morphology (appearance/shape)

Why is a semen analysis needed?

It is usually done as part of fertility workup as a third of couples who have difficulty conceiving may have male factor related infertility. 

Do I need to prepare for the test?

• Abstain from sex, masturbation, alcohol, caffeine for at least 3 to 6 days before semen collection 
• Avoid herbal or hormone medications (discuss with your gynaecologist if you are on any medications)

How do I do this test?

The best way to collect semen for a semen analysis is through masturbation. You may opt to do it at home, or your designated lab will have facilities for you to collect there. A few tips:

• Empty your bladder 
• Wash your hands and penis thoroughly with water (do not use soap)
• Wipe dry with clean paper towels 
• Masturbate and collect the semen into the provided semen bottle 
• Keep bottle at room temperature 
• Submit bottle to the designated lab within 60 minutes of collection (if done at home)

If there was spillage during collection, do not attempt to collect the spillage to add to the bottle. You simply need to let the lab know that there was spillage.

What is considered a normal result for semen analysis?

The World Health Organisation values for a normal semen analysis is as follows:

*PR: progressive motility, NP: non progressive

My semen analysis came back abnormal. Why is that?

This can be due to a variety of factors, including:

• Your general health
• Smoking and alcohol
• Medical problems e.g. kidney disease, depression, cancer etc 
• Previous surgeries on testes: resulting in blockages
• Genetic conditions: abnormal chromosomes affecting sperm production or male reproductive tract development 
• Retrograde ejaculation
• Varicoceles (swollen veins in scrotum)
• Infection e.g. sexually transmitted infections (STIs) or childhood infections (mumps) 
• Anti-sperm antibodies 
• Hormones: low levels of hormones required for sperm production (this may be caused by external factors e.g. taking steroids for bodybuilding)

Can I improve my sperm count?

This depends on the cause. Possible ways to do so include:

• changing your lifestyle e.g. stop smoking/alcohol, improve control of your medical conditions, reduce stress, maintaining a healthy body mass index (BMI)
• wear loose boxers 
• taking vitamins that boost male fertility: your gynaecologist will be able to advise you on this
• medication or counselling 
• antibiotics: in cases of infection 
• surgery: if varicocele or blockages are detected 
• hormone medications: in certain cases 

You may need to see a urologist for further advice. 

What are my options for fertility?

There are many option of assisted reproductive techniques that can help with low sperm count including:

• intrauterine insemination
• in-vitro fertilisation
• IVF with intracystoplasmic sperm injection (ICSI)

Depending on the results of your partner’s fertility check, your gynaecologist will be able to advise you further on this.