Updated: Nov 19, 2020
If a basic semen analysis carried out by a local laboratory show that there are anomalies within it, or have been having difficulties conceiving for two years - it may be advised to get a referral to an 'Andrologist'. If a couple are over 35 years of age, and due to the time factor it would also be advised to begin investigations after 0ne year of trying to conceive.
There are specific measurements in which a more detailed semen analysis can provide in order to find out the overall performance of sperm, measurements such as:
(1) - Liquefaction /Viscosity - at the point of ejaculation semen changes its composition from being viscous to becoming liquefied. This process usually takes around twenty minutes at room temperature. This process is important in providing a watery solution that is alkaline in which the sperm can swim through. if the process of liquefaction is poor this can inhibit the journey of the sperm through the cervix - a solution if assisted conception is needed is for the sperm to be washed and mixed with a more suitable solution.
(2) - PH - A normal PH level of semen should be between 7.2 and 8 - which should be alkaline to help to protect sperm from the acidity of the vagina. A sample that is acidic could indicate an absence of the Vas deferens.
(3) - Debris - Anything that should not be there and cant be identified as sperm, such as:
Cellular debris from the Vas deferens/Prostate/Seminal vesicles and the Urethra.
Leukocytes (white blood cells) - a colourless cell which circulates in the blood and body fluids (semen) - and is involved in counteracting foreign substances and disease. High numbers would indicate elevated free radicals and possible infection.
Erythrocytes (red blood cells) - which contain the pigment haemoglobin - which imports the red colour to blood - and transports oxygen and carbon dioxide to and from the tissues. They should not be present in any ejaculate - it usually indicates inflammation/obstruction/disease - which would need further investigation.
(4) Agglutination - When groups of sperm are stuck together (clumped) - this is usually an indicator of the presence of antibodies - in which the man's Immune System has identified the clumps of sperm as "foreign bodies" and try to destroy them. High levels of agglutination can be an indication of infection, which can be treated with antibiotics.
(5) Anti-sperm Antibodies - These are detected by a MAR (Mixed Agglutination Reaction) test - it is carried out on the semen rather than the blood. The test provides an indicator of the level of sperm being identified as foreign, causing them to clump together.
(6) DNA Fragmentation - A test to assess the genetic makeup of the sperm - which provides valuable information on chromosomal abnormalities. It provides information that helps in the clinical diagnosis, management and treatment of male infertility. Most genetic abnormalities are inherited - while other contributing factors for DNA fragmentation is "Oxidative Stress" - which can be associated with one or more of the following:
Elevated Testicular Temperature
Environmental and Occupational Pollutants
Advanced Chronological Age
The results of a basic semen analysis are only indicators - and can only help guide the likely cause of a problem. If the is normal and your partner has no detectable cause of infertility - your gp may suggest other more advanced testing such as DNA fragmentation - or there is enough information to start fertility treatment.
If the results are below normal levels - the chances of getting pregnant without fertility treatment are greatly reduced.