Semen analysis: How to understand the report and What the normal values are.

February 9, 2023 Helal Medical

Semen analysis, a medical test that evaluates the fertility status of a man, with data in the test report about the quantity and quality of sperm produced. Also, it detects the presence of infection in the semen. Purpose of semen analysis is to assess a man’s fertility. that can help to diagnose the causes of infertility in couples who have difficulty conceiving.

Sample Collection for semen analysis

How to do semen analysis: A semen sample is collected in a sterile container and sent to a laboratory for analysis. The sample can be collected in the laboratory or at home and delivered to the laboratory within an hour.
Collection method (in laboratory or at home): The sample can be collected in the laboratory or at home with the help of a partner. The best option is to collect the sample at the laboratory to ensure quick delivery and proper fluidity.
Importance of quick delivery to the laboratory: Quick delivery of the sample to the laboratory is important to ensure proper results. A delay in delivery can affect the fluidity of the sample and the results of the analysis.

semen analysis in infertility cases:

Semen analysis is an essential part of the diagnostic process for couples facing infertility. The report provides valuable information about the fertility status of the man. By understanding the results of a semen analysis report, couples can take appropriate steps to address any underlying issues and increase their chances of conception.

The semen analysis report tells the condition of important data and factors such as the sample volume, liquefaction time, acidity level, and microscopic examination. The microscopic examination, which is the most important part of the test, includes the sperm number, shape, movement. And the number of white blood cells in the sample and the level of some important constituents such as sugar (fructose) in the sample.

Semen Analysis Report:

The semen analysis report is a detailed report of the results obtained from the laboratory after analyzing the semen sample.
When to do the test: A semen analysis should be done if a couple has been married for more than a year without pregnancy. Infertility is defined as the inability to conceive after one year of marital intercourse.

The report usually displays 3 sections as follows:

Section 1: Information about the semen sample: This section includes information recorded by the laboratory about the sample, such as the period of abstinence from sexual intercourse, the time of collecting the sample, and the liquefaction time.
Section 2: Physical characteristics examined (naked eye or medical solutions): This section examines the physical characteristics of the sample, either with the naked eye or with medical solutions.
Section 3: Microscopic examination of the sample: This section includes the results of the microscopic examination of the sample, including the number, shape, and movement of sperm and the number of white blood cells in the sample. The level of sugar (fructose) in the sample is also analyzed.

Section Two: Physical Characteristics

It contains the physical characteristics of the semen sample, which are as follows:

Appearance of the sample (transparent or opaque – cloudy)
The color of the sample: the natural color is closer to light gray, and the color change indicates a problem. For example, a color close to red may indicate the presence of blood in the sample.
Is the sample liquid when collected or is it coherent? It is normal for the semen to flow in a period not exceeding 20 minutes, and if after a longer period it may indicate an infection in the seminal vesicles or prostate.
The volume of the sample, which should be more than 2 milliliters in normal cases. The normal volume ranges from 2 to 5 milliliters, and if: the volume is much less than that, and continues at all times of ejaculation, it may cause delayed childbearing.
Acidity level: the normal range is between 7.2-7.8. If it is outside this range (low or high), this could lead to the death of the sperm or a weakness in its movement.

Section Three: Microscopic Examination

The microscopic examination is the most important part of the semen analysis, as it provides information on the quality and quantity of sperm, as well as the presence of any abnormal cells or substances. The following are the results of the microscopic examination:

A- Sperm Information

Sperm count: Sperm count refers to the number of sperm present in the sample. It is expressed as the number of sperm per milliliter of semen. A normal sperm count is considered to be 40 million sperm or more in the sample, or 15 million sperm per milliliter. A low sperm count can have several causes, including hormonal diseases, bacterial infections, chemical injury to the testicles, and others.

Sperm motility: Sperm motility refers to the ability of sperm to move and swim. It is expressed as a percentage of the total number of sperm in the sample. The semen analysis report indicates the percentage of motile sperm, the percentage of sperm with fast forward movement, the percentage of sperm moving slowly or in place, and the percentage of immobile sperm.

Sperm shape: The shape of the sperm is also evaluated as part of the semen analysis. The percentage of sperm with normal shapes and abnormal shapes is determined. The location of the abnormality in the sperm shape is also noted, such as the proportion of sperm with abnormal heads, necks, or tails.

B- Other Information

White blood cells (pus cells): The presence of white blood cells in the semen is an indicator of infection. A normal semen sample should not contain white blood cells.

Red blood cells: The number of red blood cells in the semen is also noted.

Other findings in the sample: Any other findings in the semen sample are also recorded in the semen analysis report.

SUMMARY

Semen analysis is a test performed to evaluate a man’s fertility and detect any infections in the semen. The test involves collecting a semen sample in a sterile container, and submitting it to a laboratory for analysis. The results are usually delivered in a semen analysis report within 4-5 hours of sample delivery.

The semen analysis is usually the first examination performed on couples struggling with infertility. The report contains information about the semen sample, its physical characteristics, and results of the microscopic examination. The information includes abstinence period, collection time, liquefaction time, appearance, color, volume, and acidity level of the sample. Understanding the results of the semen analysis can help in determining the cause of infertility and guide further treatment options.