When you meet with a physician, comprehensive fertility testing and a thorough medical evaluation will occur to evaluate personal fertility potential of both partners. This testing is commonly covered by insurance or offered for a low fee that is far less than the combined cost of several over the counter tests. Some centers will remove the fee completely if treatment is pursued after testing.

Men will experience a physical examination to check for a varicocele, a varicose vein present on the scrotum, or other abnormalities that can impact sexual function or sperm production. This examination is typically done by a urologist.

Men will also provide a sperm sample that will be assessed by a laboratory professional based upon six parameters:

  • Volume – The normal volume in a sperm sample is between ¼ -1 teaspoon, or 1.5-5 mL.   Low volume can indicate dehydration but could also be due to a blockage or dysfunction.
  • Sperm Concentration – A normal concentration is approximately 15 million or higher. Lower numbers may indicate a blockage or issue with sperm production.
  • Motility – This focuses on the sperm’s ability to move and should be above 40 percent. A lower number may indicate exposures to things such as smoking, alcohol, caffeine,  chemicals, or drugs. Low motility can also indicate hormonal problems or a varicocele.
  • Morphology – This focuses on the shape of the sperm, which includes the head and tail. Chances of pregnancy decrease if there is a large presence of abnormally shaped sperm. This may also affect recommendations on treatment to optimize your fertility potential
  • Total Motile Count – The total amount of moving sperm. Normal sperm samples have at least 20 million moving sperm, optimally 40 million or more. Intrauterine Insemination may be helpful if the total motile count is between 10-20 million (minimum 5-10 million). In Vitro Fertilization may be recommended when there are less than 10 million moving sperm.  
  • Other factors such as the presence of white blood cells or increased round cells may indicate inflammation or infection.

For best results, men must abstain from sexual activity between 2 to 5 days before producing a specimen.

 

When to Skip Tests and Seek Medical Guidance:

If a man has undergone cancer treatment, is on any medication that can hinder fertility such as testosterone, has difficulty achieving or sustaining an erection, is taking supplements for athletic performance, has experienced any trauma to the genital area or suspects any semen issues, visit a doctor for a semen analysis and medical examination.

 

Author: Dr. Asima Ahmad, Fertility Centers of Illinois