Traditional Semen Analysis
The semen analysis remains one of the single most important tests to assess a man’s fertility. A semen analysis is usually performed on a specimen delivered after 48 to 72 hours of ejaculation. A semen analysis is best obtained by masturbation to a wide mouth container with 2 to 3 days of abstinence. It is best analyzed within 2 to 3 hours of collection and special instructions are generally given for the handling of this specimen prior to analysis. Two or three semen analyses over the course of 3 to 4 weeks are generally considered ideal for accurate measurement of fertility problems.
Important parameters are measured including the volume of ejaculation, the total concentration, the total number, the percentage moving, the characteristics of the movement, the number of white blood cells, a categorization of the shape of the sperm and other particulate matter that may exist within the semen sample.
All of these aspects can suggest important impactors on male fertility. Low sperm volume can suggest a blockage or low testosterone levels. Certain prostate diseases may also contribute as well as abnormalities of orgasmic function that can play a role in low sperm volume. Diabetic patients and other patients with potential neurologic conditions can experience a condition called retrograde ejaculation which also will present with a lower ejaculate volume.
There are many contributors to low sperm concentration including hormonal and genetic causes. Some of these are reversible and will be investigated as part of the initial evaluation.
Motility and sperm progression are often signs of lifestyle abnormalities and can be a sign that a varicocele could be causing fertility difficulties. Abnormalities in the remainder of the semen analysis will be dealt with specifically.
Traditional semen analysis performed for fertility reasons can be performed in any one of our three offices at a cost of $25. Having a semen analysis and our office affords you a more convenient drop-off location and assures that your specimen will be read by a fertility specialist.
Advanced Semen Analysis – DNA Testing
The traditional semen analysis does a general anatomic and numeric calculation of fertility. We now know that there may be other aspects that cannot be seen with the naked eye and may require advanced testing.
We offer an advanced semen report through a company called ReproSource®. Genetic material is carried in our DNA and can be analyzed for damage. It is possible that DNA damage could lead to abnormal sperm function and reduced fertility.
A sperm sample is collected and the amount of DNA damage is calculated using a variety of methods including:
- Sperm Chromatin Structure Assay (SCSA) Testing
- Terminal Deoxynucleotide Transferase dUTP Nick End Labeling (TUNEL) Assay
- Single-cell Gel Electrophoresis (COMET) Assay
This company will look at DNA Integrity as well as changes that can occur due to inflammation. This test can impart important information for men having a normal semen analysis and no other obvious cause for ongoing infertility.
Some studies have shown decreased chances of getting pregnant naturally or with intrauterine insemination (IUI) with higher amounts of DNA damage. Such findings may prompt additional lifestyle changes or even surgical correction of conditions such as a varicocele.