The semen analysis is the cornerstone of testing for male infertility
problems. This test provides important information about the quality
and quantity of the sperm. The semen sample is analyzed for volume,
viscosity (thickness), pH and color of the ejaculate, sperm concentration,
motility, morphology, and forward progression of the sperm. The
sample is also examined for the presence of white or red blood cells
which may indicate infection or inflammation. We perform both manual
and computer assisted semen analyses (CASA). From this simple test,
we can tell how many sperm are present, how many appear normal and
how many are moving. A semen analysis does not assess sperm
function. It dcoes not answer the question “ar the sperm good
enough to conceive”. More sophisticated tests of sperm quality
such as the Sperm Chromatin Structure Assay (SCSA) can better help
asses the “health” of the sperm.
The normal semen parameters established by the World Health Organization
are:
Volume
1.5-5.0 ml
Sperm Density
>20 million sperm/ml
Motility
>50%
Morphology
>30% normal forms
Forward Progression
(scale 1-4) 2+
Viscosity No Hyperviscosity
White blood cells
0-5 per high power field
Collection Instructions
The semen sample should be collected at the laboratory in a special
sterile container after a 2-3 day period of abstinence from ejaculation.
Alternatively, the sample may be brought in from home within 1 hour
of ejaculation. The sample should be maintained at body
temperature which can easily be done by placing the container in
a shirt pocket. No lubrication should be used while obtaining the
sample as it can be toxic to sperm. Occasionally, due to religious
reasons, the sample may have to be obtained during intercourse.
A special condom designed for this purpose will be provided.
A minimum of two semen analyses provided several weeks apart, and
collected in a similar manner, is recommended because sperm counts
tend to fluctuate. We never rely solely on one sperm count.
Dr. Werthman was chosen as the 2008 American Fertility Association's
Illuminations award recipient for his more than decade-long
accomplishments in the field of male reproductive medicine and success
in helping couples conceive. This is the highest award a fertility
doctor can receive
Dr. Werthman was featured on ABC's Prime Time TV show "Extreme Makeover" where he joined a team of world-class reconstructive surgeons. Dr. Werthman was carefully chosen by the show's producers as their vasectomy reversal expert and fertility specialist. He performs a vasectomy reversal on the season's premier episode.
Infertility and Reproductive Medicine - Clinics of North America
Philip Werthman, MD
(Guest Editor)
"...this book is dedicated to my patients who have allowed me the privilege of touching their lives by helping them start families." - Dr. Philip Werthman