What is semen analysis?
Semen analysis is the first test ordered in the management of male infertility. In this preliminary assessment we look at certain physical characteristics like volume or quantity of the ejaculate, pH, time taken to liquefy & levels of fructose. Microscopic examination helps us to measure the count or the concentration, motility of the sperm (forward), morphological characteristics of the sperm (size and shape) & concentration of white blood cells. This basic analysis guides the clinician to proceed further and manage accordingly.
Repeat semen measurements from the same individual will vary over time. This has prompted the suggestion that two or three semen samples are needed in order to establish a reliable semen profile.
However, as the WHO criteria provide a sensitive test if the semen analysis is normal there is no need for a repeat analysis.
It is usually suggested that a repeat semen analysis should be performed only if the result of the first analysis is abnormal. Biologically, the optimal time for the second sample is at least three months after the initial sample because the cycle of spermatozoa formation takes about three months to complete. However, this delay may cause anxiety and the timing of the second sample should take into consideration the preferences of the man. If azoospermia or severe oligozoospermia is reported in the initial semen analysis, a repeat test should be undertaken within two to four weeks.
Low sperm count or quality is found to be the only cause of infertility in about 20% of couples, and is a contributory factor in a further 25% of couples.
It is estimated that in between 30% and 50% of men with poor semen quality no cause for this will be identified.