Male infertility can result from issues related to sperm production or function, hormones, or the reproductive system. ¹ Semen analysis is one of the tests performed to assess male reproductive health. It provides details on various parameters such as sperm count, motility, and morphology and helps healthcare professionals determine whether more tests should be conducted. ² For men who require fertility testing, LifeCell’s Ayushman Male Infertility Panel may also be included in the overall battery of health tests based on certain conditions.
What Is Male Infertility?
Infertility is normally characterised by an inability to conceive despite having frequent, unprotected sexual intercourse for a period of at least twelve months. It can be caused by male infertility, female infertility, a combination of both, or situations where a specific cause cannot be identified.
Male infertility can be caused by issues such as impaired sperm production or function, difficulty ejaculating, blockage of the reproductive system, as well as some hormonal, genetic, and structural disorders.
What Is a Semen Analysis?
Semen analysis refers to a laboratory test performed on semen and is among the first tests that are performed during male infertility evaluation.
- What Does a Semen Analysis Measure?
A basic semen test can be used to evaluate several characteristics of the sample such as semen volume, sperm concentration, total number of sperm, sperm motility, sperm viability, and sperm morphology.
Sperm concentration refers to the number of sperm in a particular amount of semen. Sperm motility refers to the movement of sperm, whereas sperm morphology refers to the structure of sperm. Sperm viability is the percentage of sperm that are alive.
- Interpretation of Semen Analysis Values
Semen analysis results are compared with WHO reference values, which are intended to aid interpretation and are not definitive criteria of male infertility.
Values below the laboratory reference range do not necessarily mean that conception cannot occur, while normal results do not guarantee conception. Therefore, results should be considered alongside the couple’s overall reproductive profile.
- Is One Semen Analysis Sufficient?
Semen parameters can vary between samples; hence, an abnormal semen analysis result may require analysis of a second sample for confirmation. According to the AUA and ASRM guidelines, at least two semen analyses, ideally obtained at least one month apart, are important, especially in cases where the initial semen analysis result is abnormal.
How Should a Man Prepare for a Semen Analysis?
It is important to follow the laboratory’s instructions, as collection and handling can influence the test results. Standardised semen collection, transport and laboratory examination methods have been recommended by WHO.
The recommended length of time to abstain from ejaculation before semen specimen collection is usually between 2 and 7 days based on the WHO laboratory method. Specimens are usually collected through masturbation into a sterile container either provided by or approved by the laboratory.
The sample should be delivered to the laboratory according to the laboratory’s prescribed procedure and within the specified time frame in order for the test to be carried out under proper conditions. ²
What Can Affect Male Fertility?
The health of the male reproductive system can be affected by various biological, medical, environmental, and lifestyle factors. Some of these are potentially modifiable, but others require medical evaluation and management.
- Medical and Reproductive Disorders
Disorders that affect the testicles, reproductive tract, or hormones may affect either sperm production or function. Varicocele, certain sexually transmitted infections, hormone disorders, genetic conditions, and reproductive tract disorders have all been linked to male infertility.
Not all men with varicocele experience infertility, and hence, its clinical significance needs to be assessed on an individual basis.
- Lifestyle and Environmental Factors
Several lifestyle and environmental factors have been studied for their potential association with male fertility and reproduction. These include smoking, excessive alcohol consumption, obesity, anabolic steroid use, recreational drug use, and psychological stress.
When Should a Man Consider a Fertility Evaluation?
Infertility testing may be considered if a couple has been unable to conceive after 12 months of regular, unprotected sexual intercourse. However, earlier testing may be recommended depending on age, medical history, and any other pre-existing problems associated with infertility.
For men undergoing fertility evaluation, another available option is LifeCell’s Ayushman Male Infertility Panel. It can be considered along with medical assessment based on the patient’s clinical needs. The specific tests performed depend on the clinical condition of the patient.
Conclusion
Male fertility may be affected by sperm production, sperm quality, hormone levels, reproductive tract conditions, genetic factors, lifestyle factors, and other health-related issues. Semen analysis is an important initial test because it provides information on sperm concentration, motility, morphology, and other features. ²
However, the outcome of semen analysis should not be considered a definitive indicator of fertility or infertility. Test results may vary from sample to sample, and abnormal test results should be confirmed through additional testing.
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