Abnormal Semen Analysis

Indicators of an Abnormal Semen Analysis

There are some basic parameters which are tested in a standard semen analysis. These include the sperm concentration, motility (i.e., sperm mobility), morphology (i.e., sperm shape), and the volume of ejaculate. The key semen analysis parameter shown below strongly influences the likelihood of a pregnancy by natural means (i.e., intercourse) and by intrauterine insemination (IUI).

Calculating the key parameter:


*The morphology parameter is not included in this calculation because it does not have independent predictive value for a natural (spontaneous) pregnancy nor IUI. Sperm morphology is more valuable at the IVF stage.

Total Motile Sperm Count

If your total motile sperm count in a given semen specimen is less than 80 million, then the likelihood of natural pregnancy is diminished. If you are undergoing IUI, your odds of achieving of pregnancy are still related to the total motile sperm count. How to increase your Total Motile Sperm Count.

Sperm Morphology

Although sperm morphology is evaluated in a standard semen analysis test, its value as a predictor of pregnancy by intercourse and IUI is limited. It does, however, have value in predicting success with IVF. When the semen morphology is less than 12% using strict criteria, it has a negative predictive value for pregnancy rates with IVF. How to increase the percentage of sperm with normal morphology?

White blood cells (WBCs) in abnormally high numbers, usually greater than 1 million per cc, is a sign of inflammation in the semen. It is important that WBC measurements stain for and document the concentration of WBCs because they can otherwise be confused for immature sperm. Studies suggest that WBCs in the semen are associated with infertility because of the potential negative impact on sperm function. How to treat WBCs in these men (i.e., leukospermia)?

pH Testing
The pH testing of the semen is not always necessary. Occasionally, it is helpful to determine if low ejaculate volumes are related to blockage of the ejaculatory ducts. A low semen pH (i.e., acidic semen) is a sign of blocked ejaculatory ducts. How can low ejaculatory volumes be treated?