From the Guidelines
Semen analysis results can indicate various conditions, including azoospermia, oligozoospermia, asthenozoospermia, teratozoospermia, and normozoospermia, which are crucial in assessing male fertility. The test evaluates several parameters, including sperm count, motility, morphology, semen volume, and pH, with normal values defined by the World Health Organization as a semen volume of at least 1.4 mL, total sperm number of 39 million per ejaculate, sperm concentration of 16 million/mL, vitality of 54% live, progressive motility of 30%, total motility of 42%, and morphologically normal forms of 4.0% 1. Azoospermia, or the absence of sperm in the ejaculate, can be further evaluated by centrifuging the ejaculate and examining the pellet for rare sperm, and may indicate obstructive or non-obstructive azoospermia. Obstructive azoospermia is suspected when physical examination reveals normal-sized testes and dilated epididymides, while non-obstructive azoospermia is more likely when testes are atrophic and FSH levels are elevated 1.
Some key points to consider when interpreting semen analysis results include:
- Low semen volume and acidic pH may indicate distal obstruction in the genital tract, such as congenital bilateral absence of the vas deferens or ejaculatory duct obstruction 1
- Karyotype testing is recommended for males with primary infertility and azoospermia or sperm concentration <5 million sperm/mL, as karyotype abnormalities are a common cause of male infertility 1
- Y-chromosome microdeletions are found in approximately 5% of severely oligospermic males, and may be a contributing factor to male infertility 1
- Scrotal ultrasound and transrectal ultrasonography (TRUS) or pelvic MRI may be used to evaluate the anatomy of the primary organs involved in ejaculation and identify potential causes of infertility, such as varicocele or ejaculatory duct obstruction 1
In terms of lifestyle modifications, avoiding tobacco, limiting alcohol, maintaining a healthy weight, reducing stress, avoiding excessive heat to the testicles, and treating any underlying medical conditions may help improve semen analysis results 1. Overall, semen analysis is a crucial diagnostic tool in assessing male fertility, and abnormal results may indicate underlying medical conditions that require further evaluation and treatment.
From the Research
Semen Analysis Results
The results of a Semen Analysis (SA) test include:
- Sperm concentration: the number of sperm per milliliter of semen 2, 3
- Sperm motility: the percentage of moving sperm 4, 2, 3
- Sperm morphology: the percentage of normal-shaped sperm 2, 3
- Sperm vitality: the percentage of live sperm 2
- Presence of round cells, leukocytes, and sperm antibodies 2
- Biochemical markers (optional) 2
Factors Affecting Semen Analysis Results
The results of a Semen Analysis can be affected by:
- Ejaculatory abstinence: the time between ejaculations, with recommendations ranging from 2-7 days 4, 2, 5, 6
- Sperm storage: longer storage in the epididymis may damage sperm quality 4
- Abstinence period: shorter abstinence periods (less than 1 day or 4 hours) may result in better sperm motility and function 4, 5, 6
Guidelines for Semen Analysis
Guidelines for semen analysis include: