Semen analysis should be part of every couple’s infertility workup. Sometimes referred to as sperm count testing, a real semen analysis includes much more than just a sperm count.
While one-third of infertility cases involves a problem with just the woman, one-third of infertility cases are a problem with just the man and another third involve problems on both sides or unexplained infertility.
This is why every infertile couple must make sure the male partner is tested. Even if a fertility problem has been identified in the female partner, that doesn't mean the male partner's fertility is normal.
Semen analysis is sometimes overlooked, especially if a fertility specialistisn’t evaluating the couple. A gynecologist may not offered this very basic male fertility test (possibly because gynecologists tend to focus on the woman’s health.)
However, insisting that you have a semen analysis right from the start may save you much heartbreak (and dollars) later. For example, if only female infertility problems are treated, but male factor infertility is involved, any fertility treatments are likely to fail.
Your doctor will probably tell you that you need to abstain from intercourse for at least two to three days prior to taking the test.
According to the American Society of Reproductive Medicine (ASRM), a semen sample should be taken no less than two to three days after sexual intercourse, and no more than seven days.
ASRM also recommends that at least two samples are collected, taken about a month apart.
The semen sample is collected by self-stimulation, or masturbation, into a sterile container.
Because most lubricants contain chemicals that can harm sperm, your doctor will likely ask you to use a "dry rub" when producing the sample.
The clinic should have a room set aside just for semen collection. They may or may not have materials to help "inspire" you for the collection, so if you know you will need something, bring a magazine or your smartphone along with you.
If obtaining a sample via masturbation is difficult for you, you may be able to collect a sample via intercourse using a specialized condom at home. Do not use just any condom, however! The chemicals in regular condoms can damage the sperm sample, skewing the results.
You may also be able to produce the sample at home via self-stimulation. Talk to your doctor about this option. A semen sample should be evaluated within a particular time frame (within two hours is generally recommended) for best results. If you live far from the fertility clinic, it might be necessary to give the sample at the office.
It’s common to feel uneasy about any medical testing, and men are often nervous providing the sample and anxious to receive the results of a semen analysis.
If you are having trouble ejaculating to produce the sample, speak to your doctor. You're not alone, and there are steps you can take to help get the semen sample.
A semen analysis test looks at...
If a sperm culture is being done, the test may also look for additional signs of infection.
According to the World Health Organization, a sperm concentration of 20 million per milliliter, and a total of at least 40 million per ejaculate, is needed for optimum fertility.
In some cases, the number of sperm may be normal, but other factors are less than ideal in the semen, and this is preventing pregnancy achievement.
For a much more detailed overview of what the test measures and why, read Understanding Semen Analysis Results: What's Normal, What's Abnormal, and Why.
If abnormal results are obtained, the first step will be to schedule another semen analysis. One abnormal test result doesn't necessarily mean there is something wrong. If you had difficulty producing a sample via masturbation, your doctor may recommend doing the test via intercourse using a specialized collection condom.
Your doctor may also order additional testing. Depending on the results, your doctor may recommend medical treatment to correct the problem, lifestyle changes, or suggest fertility treatments.
Semen analysis results can be tricky to understand, as there are varying standards. Your sperm count results may fall under “normal” on one scale and “below normal” on another.
As always, speak to your doctor if you don’t understand the results.
It's not uncommon for some men to refuse or be hesitant about semen analysis testing. Reasons men have for not wanting to do the test include fear of having their "manhood" judged, religious objections to collecting the sample, or embarrassment regarding the method of collection.
Discuss with your doctor any concerns or fears you have regarding the test. Skipping male fertility testing can lead to heartbreak and lost time, if later it's discovered male fertility factors were relevant.
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