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Infertility Investigations

Semen Analysis

In order to obtain an accurate picture of semen quality, a minimum of two or three
semen analyses are required. It is essential that the laboratory performing these tests
is fully conversant with modern test requirements (WHO or Strict Criteria) as male
problems are all too frequently missed. This area of testing is most important as today,
all to often, IVF overcomes so many male problems that laboratories that test sperm
often do very poor tests and so the male component of fertility which constitutes 50%
of the equation is missed. By undertaking accurate tests sometimes simpler and less expensive approaches to treatment are possible and in the long term accurate testing
may enable scientists to determine the causes of the problem rather than just offering treatment.

Prior to testing, the laboratory should advise on the required period of abstinence from intercourse or masturbation, usually three days. Abstinence for longer than a week is not advisable.

Although alternative arrangements can be made if necessary, it is preferable for a sample
to be produced by masturbation at the laboratory. If it is to be collected at home, delays in transporting it and care of samples in transport need to be discussed with the laboratory.

In cases where the male is prohibited by religious laws or is unable to masturbate, the question of collection should be discussed with the counselling doctor and options such
as non-toxic condoms considered.

A semen analysis is incomplete if it does not include the full physical profile, structural and motility tests, and preferably mixed antibody reaction (MAR), supravital staining, and survival over time. Male and female blood, antisperm antibody tests may be necessary. Incomplete testing leads to incomplete diagnosis.

One factor, which often leads to confusion amongst patients, is the 72-day± delay between sperm production and release. A semen analysis performed on a certain day actually reveals the status of sperm formed three months prior to the time the test was undertaken.