What is a semen analysis?
A semen analysis accurately measures the number of sperm, their motility (ability to move), their morphology (size and shape), and the volume and consistency of the ejaculated sample. A semen analysis is the most important male infertility test.
A normal semen analysis result would show a sperm count of at least 20million sperm per mL, with at least half showing forward progressive movement.
Book a semen analysis
If you are a current IVFAustralia patient, your fertility specialist will provide a request form and you will need to call your local clinic to book an appointment.
If you are not currently an IVFAustralia patient, you can ask your GP for a referral to IVFAustralia for a semen analysis. IVFAustralia runs semen analysis services at its clinics in Sydney, Central Coast, Newcastle and Canberra by appointment.
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How does a semen analysis work?
You will need to produce a semen sample by masturbation, following 3 days abstinence from ejaculation. Collect the entire amount ejaculated in a sterile specimen container and bring it to one of our andrology labs, located throughout Sydney, Central Coast, Newcastle, or Canberra. It is essential to first make an appointment with one of our laboratories, so that the semen sample can be analysed within one hour, in order to avoid compromising the sample.
If you prefer, you can produce the sample in a private room at one of IVFAustralia’s clinics.
Our andrology scientists then assess semen appearance, colour, pH and Leukocyte presence. They count the sperm numbers (concentration) and the sperm motility (how fast sperm are moving).
The morphology (shape) of sperm is also assessed. If indicated, the sperm vitality can also be counted (the percentage of immotile sperm that are alive or dead) based on the effects of a dye on the sperm.
If we find abnormalities, we often require repeat tests to assess the type and degree of the problem, and whether it is a persistent feature. Sperm have a lifecycle of 72 days, so if you are ill or stressed it can temporarily affect your sperm production quality.
Sperm DNA Fragmentation test
For some patients, we may recommend testing for DNA fragmentation within the sperm.
If you have experienced recurrent miscarriage, or several unsuccessful treatment cycles, this can help us diagnose and treat high levels of DNA fragmentation. It is also useful for men who have elevated leukocyte levels in the semen, have been exposed to toxic substances, are over 40 years of age, or have diabetes.
The SCSA (sperm chromatin structure assay) test measures the stability of the chromatin and provides an estimate of the level of DNA damage in the sperm.
Sperm antibodies test
If sperm stick to each other head-to-head, tail-to-tail or in a mixed way, this is known as agglutination, and the presence of sperm antibodies may be the cause. Put simply, that means you’ve developed antibodies against your own sperm, and it can significantly affect sperm penetration into the cervical mucus, and the success of any IVF treatment. This can be diagnosed through more sophisticated techniques conducted as part of a semen analysis. This is most common in men who have had a vasectomy.
Causes of male infertility
Male infertility is caused by problems that affect sperm production or the transport process such as:
- Blocked / absent vas deferens (tubes)
- Low sperm number and/or poor sperm production
- High numbers of abnormally shaped sperm
- Failure of sperm production
- Anti-sperm antibodies
- Sperm DNA fragmentation
In rare cases, a genetic disease such as cystic fibrosis or a chromosomal abnormality could affect male fertility.
Some men may have more serious medical problems, such as low male sex hormones, or testosterone levels.
How do you treat male infertility?
Intracytoplasmic Sperm Injection (ICSI)
If you have a low sperm count, poor sperm movement, or high numbers of abnormally shaped sperm, then Intracytoplasmic Sperm Injection (ICSI) can be used as part of your IVF treatment cycle.
Digital High Magnification
For men with severely reduced levels of sperm morphology or with high levels of DNA fragmentation, Digital High Magnification of Sperm offers couples significant increases in fertilisation and pregnancy rates.
This technique allows the laboratory to enlarge images of sperm to over 7300x magnification (compared to 200-400x in standard ICSI), and pick the most appropriate sperm based on size and shape for fertilisation to be injected into the egg.
A vasectomy reversal is a day surgical procedure performed to re-establish the sperm pathway following a vasectomy. The success of a reversal is dependent on the length of time since the vasectomy, amount of vas removed and presence of antibodies. An alternative to a vasectomy reversal is a sperm retrieval in conjunction with an IVF or ICSI cycle.
Watch video: Male infertility assessment & treatment