Sperm Testing

The first test used to diagnose male infertility is semen analysis. Very simply, the man provides a semen sample, which is sent to a lab for evaluation. Through this sample the sperm are tested to determine the quality of the sperm.

Semen Analysis

This test reports on "sperm quality," which is comprised of the following: Sperm count or concentration (number of sperm), sperm motility (movement), and sperm morphology (shape of the sperm). All three aspects are closely linked with fertility rates. Note that semen analysis should be performed at least twice to confirm results.

Sperm count or concentration (also known as sperm density) is measured in millions of sperm per milliliter of semen. Any number greater than or equal to 20 million per milliliter (or more than 80 million sperm in one ejaculation) is considered normal. The fewer the sperm, the less likely a couple will be able to conceive.

Sperm motility refers to the motion of sperm. Slow-moving sperm are less likely to penetrate an egg and get a woman pregnant. Motility also tests for direction. Healthy sperm progress in a straight line. If fewer than half the sperm are motile, another "stain" test is performed to determine the percentage of dead sperm. This test is called a sperm viability test.

Sperm morphology analysis is the testing of a sperm's shape, size, and appearance. Any abnormalities lower the chances of fertility.

When Should Sperm Be Tested?

Semen analysis should be performed whenever a couple is experiencing infertility. Compared to the invasive nature of some female infertility tests, testing sperm is easy. Remember that an estimated one-third of infertility cases are attributed to male infertility, another third to female infertility, and yet another third area to problems in both the man and woman. Testing for sperm early on can save a couple stress, heartache, and money. Moreover, the sooner the problem is identified, the sooner it can be treated.

Other Sperm Tests

Most of the time semen analysis is sufficient to diagnosis male infertility, however sometimes other testing is required.

Blood Work: Blood work is used to check hormone levels of testosterone and FSH (follicle-stimulating hormone, which stimulates production of sperm.

Genetic Karyotyping: This test is performed to evaluate a couple with a history of miscarriage or to assess children with features or developmental delays that indicate a genetic abnormality. Karyotyping analyzes chromosomes in a sample of cells. The number of chromosomes and any structural changes can help identify genetic disorders or diseases.

Urine Testing (Post-Ejaculatory Urinalysis): This test checks for retrograde ejaculation (reverse ejaculation), a potential cause of male infertility in which semen enters the bladder during orgasm instead of leaving the body through the urethra. To treat this condition, sperm can be retrieved from the bladder and then used to fertilize an egg outside of a woman's body, in a laboratory, as part of a procedure called in vitro fertilization (IVF).

Testicular Biopsy: This surgical procedure is used to confirm an obstruction in the male reproductive tract and involves the removal of a small sample of testicular tissue. Given the risk of damage to the testicles, this test is usually a 'last resort' once other tests are inconclusive.

Vasography: This is a special x-ray involving the injection of radioactive dye into the male reproductive tract. This test is used when an obstruction is suspected in the ejaculatory ducts or in the vas deferens, the tube that carries the sperm from the testes to the urethra.

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