As in previous blog posts the sperm test is made up of a variety of parameters. These are useful to gage a general view on the health of the male. The WHO set the parameters that all GPS or urologists use regarding a healthy level. Sperm Count is regarded by this to be 15 million per milliliter (ml), or at least 39 million per ejaculate. If this is under 15 milliom this is considered low. As you may expect as testosterone is the driver of this a routine hormone test will show if there are issues with testosterone and other factors like FSH, LH and prolactin. 

 
There may also be a hindering physiological issue that impede sperm getting to larger numbers, which has to be ruled out. But in terms of lifestyle, a good healthy diet is the key starting point. 

Why is this so important surely it only takes 1 sperm to get there? Sadly of the many  millions that are released the more you have the more chances that the calculation of around 50-100 sperm getting to the egg make it as the ‘ best possible winners’ 

Vitamin C

Including vitamin C in your diet through fruit and veggies such as mango, papaya, broccoli, cabbage, kiwi fruit, chilis, potatoes, camu camu, spinach and ontop of this adding in 1,000-mg vitamin C supplements twice a day for up to 2 months increased sperm count by more than 100% https://pubmed.ncbi.nlm.nih.gov/17004914/ 

Also, taking zinc supplements increases testosterone levels and sperm count in those who are low in zinc https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/ 

Folate 

The key to DNA replication is just as important in Men as it is in Women for creating good quality reproductive ‘money makers’ you can get folate in leafy green such as  Kale, cabbage, Watercress,  Brocholi, Beans and legumes like chickpeas/garbanzas spinach, Brussel sprouts and spouted broccoli seeds, Beetroots or beet greens. Also organ meat like liver is a great source  https://pubmed.ncbi.nlm.nih.gov/11172823/ 

Selenium is needed to make healthy sperm and boost count. Foods such as Brazil nuts, fish, meat and eggs provide selenium.

Vitamin D

In a 2018 review low levels of vitamin D can have an effect on fertility. The best way to increase this in diet is oily boney fish. But in terms of sunlight this is the gold standard to improve levels. However in most cases like thos who live in colder climates that rarely tips the mercery higher than a fewq weeks a year a vitamin D supplement to therapeutic levels is needed. 

https://pubmed.ncbi.nlm.nih.gov/31561004/

Semen parameters

Although some cases of male fertility are due to physical reasons such as varicoceles or block ducts etc it is estimated that 40-90% are due to poor semen quality.

How do we know this. – we test always!

There are many parts to a Semen or Sperm test. 

The WHO hasn’t changed it’s criteria on since 2010, but I have seen varying parameters even in NHS test. I rarely see a good one these days so anecdotally can corroborate that levels are going down. 

A semen analysis tests for the following:

• number of sperm (volume)
• shape of sperm
• movement of sperm, or  sperm motility 

Amount.

A normal amount is between 1.5 – 5 mL, or between ¼ – 1 teaspoon. 

Viscosity

Looking for a good liquid balance not too clumpy which can hinder sperm on the journey. Usual response – normal or abnormal. 

Liquefaction 

Needs to happen by 20 mins- if taking longer there maybe and issue that needs looking into. 

Total sperm

WHO numbers – 39 million plus for a good example. 

Concentration .

WHO state that the concentration per sample needs to be jam packed to the tune of 15-20 million. If lower in IVF they recommend ICSI instead. 

Motility

How many sperm are motile. This needs to be 50+% I always laugh when clients talk about this as they call this ‘mobility’ I imagine sperm on scooters! ????

Total motile count

This should be 20-40 million moving. If it’s less and there are morphology ( shape and mutations) they may suggest ICSI if going for IVF. 

Morphology 

Shape of sperm. Should be over 4% good morphology ideally 9+.  If lots of tail, double heads and neck issues this can mean something needs to be addressed lifestyle wise.

PH

The vagina, is very acidic to ward off infection so sperm pH needs to range between 7.2 and 8 according to WHO. Ideally less than 8, but this is still acceptable.

Testing is always a must in my clinic and it’s not just about the ladies! If there have been miscarriages one of the first things I ask the couple to do is to test the sperm.

morphology which was found to be higher in the winter and spring compared to the summer. 

For the latest WHO document detailing this to a greater degree  click here