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