Thirty per cent of infertility cases affecting couples who are trying to have a baby are attributed to male-factor infertility. Male infertility can be caused by low sperm production, issues with sperm delivery, as well as illness, injury and overall health. To determine whether a man has a reproductive problem, a fertility specialist can request a semen analysis. The results are very important in diagnosing male infertility as well as choosing the best fertility treatment for a couple.
A semen analysis measures quality of a man’s semen sample to determine his level of fertility. This test includes a sperm count. According to the latest WHO recommendations, a normal sperm count is 16 million sperm per ml.
In order to analyse your sperm health, a basic semen analysis assesses the following:
Following your semen assessment, results may indicate a conservative approach to treatment, such as IUI whereas a reduction in count or motility may suggest the need for the more advanced technique of ICSI .
Sperm testing is a straight forward test. Your fertility specialist will request that you bring a semen sample, usually collected by masturbation, into the clinic for testing in our andrology labs. No lubricants should be used as they might kill the sperm.
They may also request a blood test, to assess for low male sex hormones that can affect fertility. Our scientists will analyse the sperm present in the semen. Depending on these results, your specialist may recommend further tests including sperm DNA fragmentation, an immunobead test or a testicular biopsy.
To learn more, please read our fact sheet: Semen assessment.
What is sperm DNA fragmentation?
Sperm DNA Fragmentation refers to DNA damage within the sperm which may affect embryo development, reduce implantation and increase the risk of miscarriage.
The DNA integrity of the sperm is essential for healthy embryo development. A high level of fragmentation may reveal an infertility cause that a semen assessment alone won’t detect.
To learn more, please read our Sperm DNA fragmentation fact sheet.
What is an immunobead test?
IBT checks for anti-sperm antibodies. The male immune system sometimes creates anti-sperm antibodies that attack sperm, preventing them from swimming. The production of these antibodies may be triggered by infection, cancer or due to surgery such as a vasectomy. The presence of antibodies can reduce the ability of the sperm to reach the egg, thus reducing or preventing fertilisation.
What is a testicular biopsy?
A testicular biopsy also known as Testicular Sperm Aspiration (TESA), is a test in which sperm is extracted directly from the testicles and analysed.
What is a testicular biopsy used for?
A testicular biopsy is performed when the male partner does not have sperm in his seminal fluid. This could be due to several factors, including a vasectomy, failed vasectomy reversal, obstruction, retrograde ejaculation (when sperm is released from the bladder), abnormal anatomy (an absence of vas deferens) or other genetic conditions.
How is a testicular biopsy performed?
Sperm are produced within tiny tubes inside the testicles. During TESA a fine needle is passed into the testicles and tubules are removed. They are processed and checked for sperm, which, if viable, can be used to fertilise eggs or frozen for future use using a specialised form of IVF (ICSI).
If you’re preparing for a semen analysis our specialists suggest abstaining from ejaculation for between two to seven days. This will ensure that the results from the test are as accurate as possible. It’s also a good idea to avoid alcohol, cigarettes, vapes and drugs as these can affect sperm quality.
We require you to provide us with a fresh sperm sample, which is collected via masturbation without the use of lubricant. The fluid is collected into a sterile container. You can produce the sample in a private room in our fertility clinics or at home. Your sample will need to be brought to our andrologists within one hour.
Your fertility specialist will advise you what changes you can make if your sperm test shows a low sperm count. There is no sure way to increase sperm count but you can improve the health of your sperm – the next FAQ provides some tips to boost sperm health.
Your specialist will advise which treatment option is best for you, however ICSI is usually suggested for very low sperm counts. To make an appointment with a fertility specialist visit this page.
To improve sperm quality, it is recommended to have a good diet, increase your antioxidant intake and reduce alcohol consumption. Regular exercise and well as avoiding smoking is also a good idea. Testosterone supplements may have a vast effect on sperm count, so it is recommended to cease these if possible. There is no sure way to increase sperm count, but all these factors will improve the health of your sperm and therefore improve fertility outcomes. Read our guide on healthy habits to enhance your sperm.
Male infertility affects thirty percent of couples and the good news is that we can easily diagnose this with sperm testing. The results of a semen analysis will allow your fertility specialist to recommend treatment. This may be as simple as making lifestyle changes to more complex treatment including:
Book an appointment with a fertility specialist to discuss your options today.
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