For an optimal semen analysis, we recommend at least 48 hours of abstinence.
A sperm specimen can be collected either at home or in our partner lab, Ovation Fertility. In the event that the specimen is collected at home, it needs to be maintained at close to body temperature and brought to our office within an hour of the time that it was collected. Specimens should be obtained by masturbation, preferably avoiding any gels or other chemicals that might interfere with the ultimate semen evaluation. Your partner can assist in the collection of the specimen, however, please follow the same guidelines described above.
Once the specimen arrives in the laboratory, it will be evaluated for multiple factors including volume, concentration (the number of sperm per volume of semen), motility (the percentage of sperm that are alive and swimming), and normal morphology. Morphology refers to the size and shape of the sperm themselves, as normal sperm are thought to be more likely to have normal chromosomes, whereas abnormally shaped sperm are thought to be more likely to be chromosomally abnormal and, therefore, non-functional.
In the event that the semen analysis shows a low sperm count, then your physician may recommend hormonal testing. Specifically, we will obtain a blood specimen for the evaluation of FSH, LH and testosterone. In the event that you suffer from erectile dysfunction, we may also check a prolactin level, as over-production of this hormone has been associated with the development of impotence. If it turns out that your hormone levels are abnormal, we may recommend treatment with one of several different medications that can easily correct these problems.
If your semen analysis is significantly abnormal, we will probably ask you to repeat the test in order to ensure that the abnormal findings are consistent.
If that is the case, we will probably refer you to a TFC partner urologist (a physician trained in the diagnosis and treatment of disorders affecting the male reproductive tract) who will perform a physical examination. This is important to rule out the presence of a testicular mass or other scrotal lesion that could adversely affect sperm production.
If your examination is normal, yet your hormone levels are abnormal, then we will probably recommend one of several types of medical treatment. The most commonly recommended treatments for abnormalities in either sperm production or function include intrauterine insemination (IUI) or in vitro fertilization.
Severe cases of male factor may require in vitro fertilization with intracytoplasmic sperm injection (ICSI), a procedure in which a single sperm can be obtained from a sperm specimen and injected directly into an egg that has been obtained from your partner. This procedure is both safe and effective, and has been used since the mid-1990s for men with severe male factor.