A semen analysis is one of the scariest parts of fertility assessment for many men. It can bring up all kinds of concerns about what this means about his masculinity, whether his partner will blame him for their fertility problem and whether the people in the lab will think less of him for showing up. So why does the doctor order this test and what can the man expect during the process?
When a couple is having problems conceiving, the first thing the doctor has to do is find out where the problems lie and then create a personalized treatment plan that bypasses the problems. Since there are sperm problems in about half of Trying To Conceive (TTC) couples, ordering a sperm test is a standard (and important) part of the preliminary investigation. A semen analysis (or sperm sample test) reports the sperm count (total number of sperm), sperm motility (percent of sperm that are swimming), sperm progression (how well they are swimming), and sperm morphology (whether they have the expected shape). Usually, the test has to be scheduled since the man is instructed to abstain from sexual activity for 2-5 days before the test.
Why would a test require abstinence when we’re trying to conceive?
It might seem illogical that a couple who is trying for a baby is told to abstain from sex. The reason for this is related to interpreting the sperm test results.
Men produce sperm continually so the longer the time between ejaculations, the more sperm there will be in the sample. But this doesn’t mean that abstaining for weeks (or even months) will give a better result on the sperm test. If the sperm are stored in the body for that long they start to die, so the semen analysis would just show lots of dead sperm. The balance is an abstinence period that is likely to give a good number of motile sperm which is around 3 days. Also, all of the normal ranges for sperm tests have been set using ejaculates from men who abstained for 2-5 days, so it’s important to maintain this scheduled abstinence for the test sample.
How is the sample collected?
The standard method for collecting a sample is by masturbation. There is a lot of research that shows that stimulation makes for better production, so the use of visuals to help in getting in the mood is just fine and even encouraged. Using a lubricant can also be a good idea – but only if it doesn’t risk damaging the sperm. Published studies over the past three decades have shown that most “everyday” lubricants and even olive oil, glycerin, saliva and water can impair sperm motility on contact in laboratory testing. Pre-Seed is the first lubricant with independent studies confirming that it does not harm human sperm.
The ejaculate is collected directly into a collection cup. It can be a technical challenge to manage all of this with just two hands, especially if you’re trying to hold a magazine as well as the collection cup… It is best to at least loosen the lid of the collection cup first. It is important to collect all of the ejaculate because most of sperm cells are in the first part. If there was a technical problem and not all of it was collected, it’s important to tell the lab staff as that can help the doctor understand the test results.
Some labs require the sperm to be collected on-site in special “collection rooms”. This can be an embarrassing thought for the man – but there isn’t a need to be concerned about what the clinic staff thinks since it’s a normal day at work for them. Sperm needs to be kept at body temperature – if they get too cold or too hot, they stop swimming – so collecting on-site means that the temperature of the sperm sample can be controlled. Other labs are fine with the man collecting at home and then dropping off the sample but this means that the sample needs to be kept at body temperature in transit. This can be done by putting the sealed collection cup in an inside pocket. Don’t ever let it get warmer than body temperature, though (putting it on a heater is not good idea). It’s also important that the sample reaches the lab as soon as possible after ejaculation– within 30 minutes is ideal.
What happens next?
If the sperm test identifies some unexpected or abnormal results, then the doctor will usually ask for a second test to confirm them. This is important because it takes sperm about 10-12 weeks to go from being formed to being ejaculated, so if the man had, say, a fever 2 or even 3 months before the first sperm test, then the sperm count or sperm motility might have been lower than normal. By ordering a repeat test, the doctor can see whether the results are consistent between the tests, which will point the way to the treatment options.
Whatever the results of the sperm test, it is important to remember that it is just one part of the puzzle in helping the doctor to understand why conception is a challenge.
Sperm collection and semen analyses can be intimidating or even scary for men when trying to conceive. Whether you are embarrassed about the collection process or worried about the results, remember why you are taking the test in the first place. Your doctor can only create a personalized TTC plan with a full picture of both partners’ reproductive health. It is worth facing