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The Semen Analysis

The single most important test of male fertility

What are they looking for?

  • Sperm count
  • Ability of sperm to swim (motility)
  • Velocity or forward progression of the sperm
  • Size and shape of the sperm (morphology)
  • Total semen volume
  • The liquefaction of the semen (the ability to go from normal gel-like state at ejaculation to a liquid state)

The Factors Reported in a Semen Analysis
A semen analysis is usually done at a laboratory or a physician's office. The man masturbates and collects the ejaculate into a cup. The semen should then be examined within a few hours, to achieve the most accurate results. The following is evaluated:

Total Volume
2 5 milliliters is a normal volume. A very low volume indicates that the seminal vesicles may not be making enough fluid or that these ducts may be blocked. It may also indicate a problem with the prostate gland.

Sperm Count
40 million to 300 million is the normal range for the number of sperm per milliliter. Counts below 10 million are considered poor; counts of 20 million or more may be fine if motility and morphology are normal.

Motility and Velocity
2 aspects of motility will be evaluated

  • The number of active cells as a percentage of the total number of cells (rated from 0-100%, at least 50% should be active)
  • The quality of the movement of the sperm (rated from 0-4. A score of 2 or more is satisfactory.)

Morphology
At least 30% of cells should be of normal shape according to the WHO (world health organization)

Kruger (strict) morphology test
Examines the shape and size of the sperm head. Normal results are when 14% or more of the sperm have normal shaped heads. Men with less than 4% of normal shaped sperm may have a significant infertility problem.

Liquefaction
Normal semen which is liquid at ejaculation immediately coagulates into a pearly gel that liquefies within 20 minutes. Failure to coagulate and then liquefy may indicate a problem with the seminal vesicles, as would increased thickness or the presence of white blood cells.

Seminal Fructose
If no sperm are present, the semen will be tested for seminal fructose, normally produced by the seminal vesicles. If no fructose is present, congenital absence of the vas deferens or seminal vesicles or obstruction of the ejaculatory duct

Cultures
The physician may test the semen and/or the urethra for the presence of ay STD's or other bacteria.

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