Do I really need to do a semen analysis?

14 Jan

I can’t count the number of times that I have been asked, “Do I really need to do a semen analysis?” Infertility is not just a “woman” issue. In the past, infertility was often believed to be due to the woman; however, studies indicate that 35-40% of infertility is related solely to a male factor. For this reason, it is very important to include the male partner in the initial evaluation of a couple’s infertility.

The single most important test of male fertility is the semen analysis. A semen analysis is usually done at a physician’s office or at a laboratory. A normal semen analysis must have a Total Volume of >2 milliliters, a Sperm Concentration (count) greater than 20 million sperm per milliliter with >40% of sperm moving progressively forward (Motility), and at least 4% of sperm being normally shaped (Morphology using Kruger strict criteria). Men with any parameter less than these normal values are considered to have an abnormal semen analysis.

The results of the semen analysis can provide insight into a couple’s fertility problems. The semen analysis helps determine if fertility treatments such as intrauterine inseminations (IUI) or in vitro fertilization with intracytoplasmic sperm injection (IVF with ICSI) is required. In most cases of an abnormal semen analysis, ICSI is recommended. This is because ICSI is so much more successful than IUI’s when it comes to abnormal semen analyses. ICSI involves the injection of a single sperm into a single egg for fertilization. ICSI is performed in conjunction with IVF and has revolutionized the ability to treat men with severe sperm abnormalities. Luckily, most cases of male factor can be successfully treated and/or bypassed so that pregnancy is possible. Even men without any sperm in the ejaculate can father children if sperm can be obtained from the epididymis or testes!

I hope that this blog answers the question, ‘Do I really need to do a semen analysis?’ and that you successfully continue on your journey from infertility to family.

Dr. Molina Dayal is the Head Physician and Medical Director at Sher Fertility in St. Louis, MO.

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9 Comments

  • Amy says:

    http://www.dailymail.co.uk/health/article-2722931/Male-infertility-treated-using-SYNTHETIC-sperm-Researchers-discover-protein-enables-successful-fertilisation.html

    This appears to be very exciting news for the world of male factor infertility. My husband and I have been struggling with MFI for 5 years now. 2 failed IVF’s and 1 failed FET through SIRM, but have been encouraged to continue on as it may be a matter of numbers for us. I’ve tested normal on all accounts and have responded fairly well in all cycles. We seem to have issues with embryo growth from day 3 to blast formation (which we have been advised is when sperm function begins to play a role in embryo development).

    Dr. Sher/SIRM- what are your thoughts on this? Although a newly discovered science Is this something you could see trickling down to clinics for use with couples like my husband and I? If so, is this something you would be interested in researching? Using?

    Thanks in advance!

    -Amy

    • Geoffrey Sher says:

      Thank you for alerting me to this interesting article . I read the publication of origin. At present the use of this protein has not been tested in humans. Time will tell whether their is potential to assist “kick starting” fertilization using this approach!

      Thanks again.

      Geoff Sher