When investigating a couple’s fertility, performing a semen analysis (also known as a sperm count) is just as important as checking for ovulation, checking the tubes are not blocked and performing a pelvic ultrasound. A semen analysis is usually considered after a couple have been trying to conceive for 12 months or more without success. 

What does the semen analysis involve?

The semen analysis looks at the number of sperm present in the semen released during ejaculation. It also looks at the number of normal looking sperm (morphology) and the sperm motility (how active the sperm are). Poor sperm motility can mean that the sperm don’t swim at the optimum rate required to reach and fertilise the egg during intercourse or insemination.

As there is a natural monthly variation in sperm quality, the health of sperm may need to be assessed over several tests, carried out at least seventy days apart. The reason for this is that sperm, whilst being continually produced by the testes, take 70 days to mature. As such, if you recheck too soon, you will just be checking sperm production at the same time as the first test. 

When deciding on the most suitable fertility treatment for a couple struggling to conceive, having the semen analysis result available is essential. If the semen analysis is normal then a wide variety to treatment options may be available (e.g. ovulation induction, tubal surgery, IVF (In Vitro Fertilisation) & IUI (intrauterine insemination)). However, if it is severely abnormal, and basic lifestyle changes do not result in an improvement, then you may need a treatment called ICSI (intracytoplasmic sperm injection). The semen analysis can also be used to check the success of the vasectomy and vasectomy reversal procedures. 

Preparing for semen analysis

To prepare for your semen analysis, consider the following: 

  • Avoid ejaculation for 48-72 hours before the sample is given. It may also be helpful to ejaculate frequently in the run up to this period of abstinence to help flush out any old and damaged sperm. 
  • Some medications can impact sperm production and sexual function. Your healthcare provider may advise stopping certain medications and supplements. It is especially important to tell your healthcare provider if you take any of the following: 
    • Any over the counter supplements, including herbal remedies
    • Protein shakes and body building drugs
    • Hair loss medication
    • Any prescribed medications (If you take any prescribed medications, do not stop taking them without consulting your doctor first).
  • Minimise alcohol, smoking and caffeine intake for at least five days before testing. 
  • Let your doctor know if you have had any recent illnesses or courses of medication. 

What can I expect on the day?

If you are attending a clinic or producing your sample at home, the process of collecting semen will be similar.

There are a variety of methods. However, the cleanest samples are achieved through masturbation. However, it can be possible to collect samples through sex with withdrawal before ejaculation or sex with a special condom, suitable for collecting an ejaculate for analysis. There are also methods of electrical ejaculation stimulation that may be possible for those unable to achieve ejaculation.

A reputable IVF treatment clinic can advise and support you to ensure your sperm sample is viable for testing. Once the sample is collected, it must be kept at body temperature. If it becomes too hot or cold, the results will not be accurate. If you decide to produce the sample at home, your sample needs to be delivered to the testing facility within the first 45 minutes of leaving the body and kept at body temperature (e.g. in your pocket) on the journey in.

Avoiding factors that can negatively impact the test sample is also essential. If the semen comes into contact with spermicide (often found in condoms), the results will not be accurate. 

Abnormal results aren’t the end of the road

An abnormal result doesn’t necessarily mean you won’t be able to achieve a pregnancy, either using assisted conception treatments or even naturally with time. Following an abnormal semen analysis your doctor may go on to recommend a repeat sperm test at a later date to ensure this wasn’t a one-off abnormal test result. If it is abnormal on repeat testing then the doctor may request some further investigations for you. These tests may include checking your hormone levels, a urine sample, examining your testes or performing genetic testing.

It is also important to remember that lifestyle changes may improve sperm health and your chances of achieving a pregnancy naturally. Remember though that any changes you make to your lifestyle (e.g. stopping smoking, cutting down on alcohol, eating more fruit and vegetables, stopping the use of body building steroids) can take several months to result in an improvement in your semen analysis result. 

What happens after your semen analysis?

Once the results of your semen analysis and your partners other fertility investigations are available, your fertility specialist can guide you and your partner through the most suitable treatment options for you.

If you are having difficulty conceiving and want to speak to a qualified fertility specialist, contact Mr Dobson’s P.A, Mandy Banbury, at mandy.banbury@circlehealthgroup.co.uk or phone 0115 9662111 to arrange a face to face or telephone appointment.