Do I really need to do a semen analysis?
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.