Men’s Fertility: Testing Sperm Health

Sperm makes up half of the equation for your baby, so it is extremely important for this part of conception not to be overlooked.

Men’s Fertility and Sperm Health

In this article, we are going to discuss:

• How to test sperm

• What to expect

• The parameters that are tested in a sperm sample

How to Test the Health of Your Sperm

Sperm Analysis

Infertility has traditionally been thought of as a concern that affects only women. However, it is now well-established that about one-third of infertility cases are actually due to the male factor.

If you have been trying to conceive for over a year without success, both partners should get a clinical workup done with a fertility expert. For the male partner, this workup includes a sperm analysis. There are several parameters that can be evaluated during a sperm analysis. They are all important to giving a realistic and accurate picture about the health of your sperm.

Before providing your sperm sample, it is important that you remain abstinent for two or three days (this includes both intercourse and masturbation). If you have ejaculated less than two days before your analysis, your sperm count can appear artificially low. If the last ejaculation occurred more than four days before the analysis, the quality of the test may be questionable. Because sperm only live for a few days, the sample will contain a lot of non-viable sperm.

It is also important that the sperm sample be fresh. Ideally, the sample should be produced at the site where it will be tested. For men who have difficulty with this, please speak to your lab. Most labs will be able to provide a container for you to collect the sample at home, but you must deliver it to the lab within about an hour of collection.

The sample will typically be tested for the following parameters:

1. Count (total number of sperm)

2. Motility (how well the sperm can swim)

3. Morphology (how they look, normally each with one head and one tail)

4. pH (degree of acidity or alkalinity)

5. Total volume of fluid

6. Agglutination (how sticky they are)

7. MAR test (for antibodies)

Let’s examine each of these parameters, and then discuss what can be done about any concerns that may arise.

Sperm Count

1. Sperm count, measured in million per milliliter (mL), is usually described as having a healthy range with a lower end of 15 million/mL. The average count is about 60 million/mL. However, I generally go with the “more is better” approach. For men with counts under 30 million/mL, there is a strong possibility that this relatively low count is a contributor to infertility concerns.

Common causes of low sperm count include the following:

- Infections

- Stress

- Hormonal imbalances

- Heat exposure

- Excessive exercise

- Steroid use

- Age

- Drug use

- Environmental toxins

- Genetic factors

Research has demonstrated that changes made to diet and lifestyle can play significant roles in improving sperm counts.

Sperm Motility

2. The sperm motility results, given as percentages, indicate how well the sperm can move. One result provides the total percentage of sperm that are moving. The other result provides the percentage of sperm that are swimming forward. These figures should, at minimum, be 40% for total movement and 32% for forward motion. If the sperm can’t move forward, there is very little chance that they will be able to meet the egg for fertilization.

Causes of poor motility, which are similar to those of poor count, involve the following:

- Age

- Weight

- Drug use

- Infections

- Heat exposure

- Excessive exercise

- Steroid use

- Zinc deficiency

- Anti-sperm antibodies

- Defects in the sperm’s tails

- Longer length of time between ejaculations

As with sperm count, there is much research suggesting that lifestyle and dietary changes can improve sperm motility.

Sperm Morphology

3. The sperm morphology parameter refers to how the sperm actually look, with the result reported based on the percentage of sperm that appear to be normal. Different labs use different parameters to assess morphology, but up to 96% of sperm can appear abnormal and a sperm sample can still be deemed as healthy. Having a poor count or motility in combination with a high percentage of abnormal sperm, means that few sperm are going to have the ability to make their way to the egg. If the percentage of abnormal sperm is greater than 96%, your specialist will likely recommend a process called intracytoplasmic sperm injection (ICSI). In this process, sperms cells are injected directly into egg cells obtained through IVF.

The causes of poor morphology are similar to those for poor counts. However, my clinical experience suggests that environmental toxins play an especially significant role in poor morphology. I often see male patients with morphology problems who work in environments with significant toxic exposure, such as mechanics, firefighters, and chemical plant operators.

Research indicates that certain supplements, including CoQ10, can be effective in improving morphology, as well as count and motility.

Sperm pH

4. The sperm pH of healthy semen is slightly alkaline, between 7.2 and 8.0 on the pH scale. The pH of semen is determined by the fluids that come from the seminal vesicles and the prostate. A pH result that is too high or too low may indicate a problem with one of these glands.

Sperm Total Volume

5. Sperm Total volume. After two or three days of not ejaculating, the total volume of semen should be about 1.5 mL or more. As with the pH, since most of the fluid comes from glands around the testicles, a low volume can point to concerns with one of these areas.

Sperm Agglutination

6. The sperm agglutination test essentially reveals how sticky the sperm is and how much of the sperm is sticking together. If there are several sperm cells clumped together, this makes it less likely like the sperm will be able to swim to meet the egg. Generally, there is increased agglutination in men who have higher levels of antibodies in their sperm (discussed further in the following MAR section).

MAR Test

7. The MAR (mixed agglutination reaction) test indicates the number of antibodies that are attacking the sperm. If more than 50% of the sperm cells are coated in antibodies, a procedure called intrauterine insemination (IUI) will typically be suggested. In IUI, sperm is inserted directly into the uterus with a catheter. If more than 80% of the sperm have antibodies, ICSI is usually recommended. There are also dietary and lifestyle changes that can help reduce antibodies and improve this parameter.

Medical Disclaimer:

The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.

Sources

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