🧔🏽 30% of infertility cases are related to male factor infertility, that is, a cause of infertility related to the male partner. As fertility doctors, even though we often care for women directly, we are also trained to evaluate males.
🔬 The first step in evaluating male infertility is a semen analysis. To do this, the male partner can provide a sample (through masturbation) which is then processed in the andrology lab and looked at under the microscope. (Sometimes males have a hard time producing a sample in the clinic, so they can bring one from home within 1-2 hours)
🧫 In a semen analysis, we look for:
✅ Semen volume and pH
✅ Sperm concentration
✅ Count
✅ Motility
✅ Morphology
✅ Debris and agglutination
✅ Leukocyte (white blood cell) count
🔎 This test can provide important information on the specific cause of infertility and can help us figure out what other tests are necessary. Depending on what we find, we often work with reproductive urologists to further evaluate and fix the problem, or we can use ICSI (intracytoplasmic sperm injection) to correct the problem.
👨🏼⚕️ How do you know if semen analysis is normal? Well, we use averages. A World Health Organization conducted a study with 4500 samples from 14 countries and compared semen analysis among couples who were fertile vs. men in the general population. They assumed that men in the lowest 5% were abnormal, and that is how they came up with ranges.
🤕 What can make a semen analysis abnormal? Previous chemotherapy, previous pelvic surgery, certain medications, testosterone injections, excessive alcohol or drug use, and extreme heat (hot tubs).
❓ I will discuss specific causes and treatments of male infertility in future posts. Any burning questions?