Lesson 3: Your Doctor, Your Options
Semen Analysis

As soon as the doctor says the words "...and we will need to do a semen analysis too", you will be able to visibly see the male partner go pale. There are many reasons why men do not want to have a semen analysis done, and only one is fear of the results. So, what we will do here is explain what a semen analysis is, why it needs to be done, and what the man can do to help ensure he will get the best results possible.

A semen analysis is one of the least invasive tests that can be done to determine if there is a fertility issue. It is also one of the least expensive tests that can be done, costing on average between $35 and $125, and many times the sample is produced either in the doctor's office or at home and then brought to the office immediately.

Many assume that an SA measures how many sperm cells are present in the sample, but an SA is more than that. The following factors are all measured in a Semen Analysis:

Quantity refers to the total number of sperm cells present in a single milliliter of semen. The normal range for this factor is 20 to 60 million sperm cells per milliliter. Motility refers to the swimming ability of the sperm cells. If they don't 'move', then they will not be able to reach the egg. A normal motility rate is 50% of the sperm cells present able to move in a straight line. Morphology refers to the development and shape of the sperm cells present in the sample. Only those cells that are mature and of normal shape and size will be able to fertilize an egg. Normal morphology is 30%. The last factor is count, or the total number of live sperm cells present in the entire semen sample. A normal count is 40 million moving sperm cells.

Because about 30% to 40% of infertility cases are due to male factor infertility, having a semen analysis done early can prevent unneeded, more expensive, testing of the woman. If, on the other hand, the semen analysis comes back normal, then it is warranted to continue with testing the woman. About 30 to 40% of infertility cases are due to female factor infertility, and about 20% are due to both female and male factors. Only about 10% of cases are unexplained, or unexplainable infertility.

So, what is a man to do to help ensure the best results possible? Actually there are a couple of things that can be done, or not done as the case may be. First, the man should refrain from ejaculating for three days prior to the test. This helps to ensure the best count possible, but three days is both the minimum and the maximum for refraining.

The next thing that can help with results is that the man should be as aroused as possible. Many doctors encourage the woman to 'help' her partner create his sample for testing. For some reason, the more aroused a man is, usually the better the results of the test. A few other things that a man can do before the test is to actually make a 'practice' run at not only producing a sample, but at getting the sample into a small container.

This may raise your eyebrow a bit, but the first bit of the sample will have the highest concentration of sperm cells. Missing this could result in less than desirable results. Even if the results of the SA are sub-normal, always remember that a second test can be, and probably should be, scheduled at least three months in the future.