Semen Analysis
What is Semen Analysis, and Why is it Necessary?
The role of sperm is to transport genetic material to the egg where fertilization and conception take place. A semen analysis (SA) is the most useful diagnostic test of sperm concentration, motility, morphology, and count. The semen analysis helps the reproductive endocrinologist determine whether a male factor infertility exists.
The collection of the SA specimen can conveniently be done here at our office where we provide two private and comfortable rooms for men. Or, they may take a collection kit home and return the sample to our office for analysis.
Once the specimen is given to personnel in our Andrology Lab, it will be analyzed for the following factors and summarized in a report.
Understanding Your Semen Analysis Results
The semen analysis is the first step in evaluating the male factor for couples undergoing an infertility evaluation. It is important to evaluate the male so the female does not go through more invasive testing or unnecessary treatments.
The semen analysis report contains several pieces of data. The most important values are volume, count, motility, and morphology. Here is a brief description of these factors and their relevance:
Volume
This measures the total volume of the ejaculate. Human semen is produced in relatively small amounts. Most men produce 1-4ml. While normal values are given on the report, there are no known causes of infertility associated with abnormal semen volume. However, too little or too much semen may interfere with proper delivery of the semen to the female during intercourse. Although this has never been proven, a short course of artificial insemination would theoretically deal with this possible problem. Some clinicians believe that high volumes are associated with infections of the prostate. This can be confirmed by semen cultures.
Count
The sperm count is given in concentration (sperm/ml) and total count. (Concentration multiplied by volume). Low sperm counts are usually assumed to be related to infertility. This is not perfect, as there are men with low counts who have children. Low sperm counts can be due to anatomical or hormonal issues, but most go unexplained.
A normal count ranges from 20 to 80 million sperm/mL (milliliter). A normal volume can range from 2.0 – 5.0 mL. To put things in perspective, an mL is approximately the amount in a teaspoon.
When low volume is reported, this can be due to various physiological reasons, including an obstruction in the ejaculatory ducts.
Men with low counts and/or motility may benefit from seeing a urologist to rule out varicocoeles or other problems in the genital tract. Hormone and sperm antibody testing may be indicated in some men.
This is usually expressed as percentage of moving sperm. Some labs will “rate” the quality of the motility by a grading system. This can be subjective. Also, some men with high counts and lower motility may still have normal amounts of moving sperm. In general, 10 million sperm with good motility per ml is probably acceptable. Possible causes of low motility include varicocoeles, infection, and sperm antibodies.
Normally shaped sperm. This can be reported by the older World Health Organization (WHO) standard, or the newer “Kruger or strict criteria.” Most fertility centers do not use the WHO standard because it does not correlate well with IVF results. In contrast, the strict criteria has been shown to predict fertilization rates with IVF. This test is performed by a licensed technician who looks at the sperm through a microscope, so there is variation between labs. Morphology does not correlate well with natural fertility. It is best used to determine how to treat sperm for couples undergoing IVF. Most centers decide what level might require intracytoplasmic sperm injection (ICSI).
Men with an abnormal semen analysis should consult with a reproductive endocrinologist. A urology consult may be indicated in some cases. Most men with an abnormal semen analysis can father children with appropriate treatment:
- TESA: a simple procedure where sperm is aspirated from the testicles using a needle
- TESE: involves a small incision in the testicles and is done in a hospital
Semen Analysis – Frequently Asked Questions
- Do you accept insurance?
- How much does the test cost?
- Do I need an appointment, or can I walk in?
- How do I make an appointment?
- What are your hours of operation?
- Do I need a doctor’s order?
- How long does it take to get my results?
- Are there any special instructions prior to my visit?
- Where will I collect my sample?
The short answer is no. RCM may be able to courtesy bill with cash payment up front (please ask Alenoosh or Pauline).
The current price for a semen analysis is $190. Pricing subject to change at any time.
Walk-ins are not accepted. An appointment is necessary.
You can call 1 (866) HRC-4IVF (4483)
Hours may vary depending on location, but we generally operate Monday-Friday, 8:00 AM-4:00 PM.
Please call our local clinic for an appointment.
Yes, a valid order from your physician is required, along with government-issued photo ID, at Check-in.
2-5 working days, though results are usually reported to your physician within two days.
The Semen Analysis test requires you to abstain from ejaculation at least 2 days and no more than 7 days, prior to your test date.
You can collect the semen sample at home and drop it off within ONE (1) HOUR after collection. You can also collect your sample at our clinics. Sterile collection containers will be provided by the clinic.