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Approximately 40% of infertility in heterosexual couples is attributable to male factors, and another 20% of infertility cases involve both female and male issues. Some of the factors may be suspected or known before attempting conception, while most might not be anticipated.

Given the significant percentage of male infertility cases associated with sperm abnormalities, a semen analysis should be among the first tests performed on aspiring parents experiencing unexplained infertility.

Common Causes of Male Infertility

Certain medical conditions or exposure to toxins can lead to damage to the sperm-producing cells or affect the release of sperm. Conditions such as undescended testes not corrected within the first year of life, cystic fibrosis, diabetes, cancer, or other chronic illnesses may also affect sperm production and/or release. Other risk factors for male infertility and/or inhibited sperm production include exposure to chemotherapy, radiation, use of supplements containing androgens (including Testosterone, DHEA, and gym workout aids), certain herbs, over-the-counter medications, and prescribed medications.

In some cases, toxin exposure or ingestion can permanently destroy the cells that produce sperm, resulting in sterility. The use of hot tubs, excessive alcohol ingestion, tobacco use, and marijuana consumption can all have adverse effects on sperm production and function. However, in other cases, there are no known exposures, health issues, or family history to account for abnormalities.

Semen Analysis / Collection Instructions and Fees

The evaluation of the semen sample includes numerous factors including concentration (number) of sperm, motility (percentage of sperm moving or swimming), and morphology (sperm shape). In addition, viscosity (thickness/ability to liquefy), presence of bacteria or white blood cells, and pH are observed. Significant abnormalities in any of these parameters will decrease the likelihood of a sufficient number of sperm being able to reach or penetrate the egg.

The specimen is collected by masturbation into a collection container after abstaining from ejaculating for 2-5 days. It is best if it can be collected at one of our office laboratories, however, if that is not possible, it may be collected at home and brought to our laboratory within 1 hour of collection time. Be sure to record the time of collection. After collecting the specimen, keep it at body temperature by placing it in your shirt pocket or wrapping it in a towel. Do not expose the specimen to extreme temperatures such as air conditioners or heater vents. More information will be provided when the procedure is scheduled.

As many minor, transient conditions can affect sperm, if an abnormality is detected, generally a second semen collection and analysis is recommended to confirm the initial result. If significant abnormalities are detected on repeated semen analysis studies, a consultation with a urologist who has special training in male infertility may be recommended. Blood work, a physical exam, and possibly a scrotal ultrasound could also be suggested.

Treatment options vary depending on the results of the evaluation and the degree or severity of the abnormalities found on the semen test. The most important initial steps include eliminating toxin exposures (including alcohol, tobacco, illegal drugs, and any form of male hormone precursors or supplements), avoiding excess heat exposure, and maintaining a healthy diet including foods rich in folic acid and antioxidants (green leafy vegetables, whole grains as well as colorful fruits and vegetables).

A urologic evaluation may reveal a problem that can be treated medically or surgically. If alterations in lifestyle do not improve semen parameters and no medical or physical problem contributing to the poor sperm qualities can be identified, then treatment options can include sperm concentration and placement into the uterus (intrauterine insemination/IUI) or in vitro fertilization (IVF) with the injection of a single sperm into each egg (intracytoplasmic sperm injection/ICSI).

A semen sample is generally considered normal when it has the following criteria:

• A sperm count between 15 million to 200 million sperm per milliliter of semen
• A sperm motility of at least 60%, meaning at least 60% of sperm present in the semen sample are capable of swimming to meet the egg
• A sperm morphology score of at least 60%, which means that at least 60% of sperm present in the semen sample have a normally shaped structure

Anything below these thresholds may indicate a fertility issue.

Yes, a man with abnormal semen parameters may still be fertile enough to impregnate someone naturally. Fertility is complex and semen parameters are only one factor that plays a role in male fertility. However, it’s important to note that abnormal semen parameters strongly correlate with fertility issues and difficulties conceiving.

Before semen analysis, men must abstain from all forms of ejaculation (including masturbation) for 2-5 days before the test. This ensures that the provided semen sample contains an accurate measure of the patient’s average sperm parameters. Men should also avoid alcohol, drugs, tobacco, high-heat situations (e.g., saunas, hot tubs, etc.), and tight-fitting underwear for at least a few days before the test. Be sure to discuss everything with your doctor before, as there may be specific instructions that need to be followed or medications to be avoided.

Male fertility testing results are typically ready within a few days of doing the test.

If a semen analysis yields any abnormal results, a second semen analysis will be scheduled to confirm the results. If the test continues to produce abnormal results, additional semen analyses will be scheduled. The tests are typically scheduled at least seven days apart from each other over the course of several months.

The Reproductive Medicine Group has many years of experience diagnosing the full spectrum of male infertility issues in Florida. With locations in North Tampa, South Tampa, Brandon, Clearwater, and Wesley Chapel, our expert team of fertility specialists is ready to answer all your questions and provide personalized fertility care. Schedule a consultation with The Reproductive Medicine Group.