Male Fertility Evaluation at Your Cryobank

Semen Analysis and Male Sperm Tests at
Fertility Center of California

Fertility Center of California offers the following semen testing in our laboratory:

Complete Semen Analysis-CSA

This represents the most complete evaluation of ejaculated sperm. 2 to 5 days of abstinence are required for optimum baseline assessment. Typically 2 to 3 semen analyses are required to get a true baseline evaluation since sperm counts can vary significantly.

Results of the semen analysis are a central component in male fertility testing. It is almost always the first fertility test ordered on a male and often times the only test. While it is useful, please note that the values of a normal semen analysis are only guidelines and are not a guarantee that significant male factor issues are not present.

The World Health Organization (WHO) has defined male infertility on the basis of concentration of sperm in semen. While concentration is useful, many other factors are measured and have clinical significance. Most male fertility specialists believe that the semen analysis is only a rudimentary test and that future testing will allow for much more in depth testing of sperm. A man is considered to be fertile by WHO criteria if he has at least 20 million sperm per ml. The average concentration of sperm for males in the U.S. was suggested to be 80 million per ml by at least one study in the U.S.

WHO Guidelines for a “normal” semen analysis

• Volume: 1.5 ml to 5.0 ml
• Concentration (number of sperm present per ml of the ejaculate): greater than 20 million/ml
• Motility (percentage of sperm moving): 50% or more
• Forward Progression (of the moving sperm the strength of their forward movement): 2+ or more
• Morphology (percentage of normally shaped sperm): 30% or more normal shapes (WHO criteria) or 14% or more (by Kruger strict criteria)
• Clumping: Minimal
• Presence of white or red blood cells: minimal
• No hyperviscosity (Thickening of seminal fluid)
• White blood cells less than 1x106/ml

Partial Semen Analysis-PSA

Typically utilized following vasectomy to verify complete absence of sperm and success of procedure.

Anti-Sperm Antibody Test-SpAB

Generally speaking, testing for antibodies on the surface of the sperm is the most clinically useful info. Serum antibody testing is of less clinical value in the male patient.
Causes of anti-sperm antibodies incl. Injury to the testicle, infection, surgical procedures, such as vasectomy.

Kruger Strict Sperm Morphology

This test looks at the shape of the sperm (morphology – shape) in a much more in-depth and critical fashion than the routine WHO method. It’s believed to have clinical significance when deciding between IUI and IVF. It is important to recognize that an abnormally low number of ”normal sperm” is not associated with an increased rate of congenital malformations (abnormal shaped child).

Retrograde Semen Analysis

This study is utilized when patients no longer have ejaculation out the tip of their penis. In certain situations such as spinal cord injury, certain medications or following surgery, the ejaculate flows backwards (retrograde) into the bladder. This process involves harvesting the sperm from the bladder which can then be washed and used for insemination (IUI) or IVF/ICSI.

Post Ejaculate Urine (PEU)

This is a diagnostic method for testing for retrograde ejaculation. This simple process is only useful for patients than can urinate. The patient voids into a specimen cup after ejaculation and the specimen is evaluated for the presence of sperm. Catherization is sometimes required if the patient is not able to completely empty his bladder.

Viability Testing

A special stain is used to determine whether sperm is viable (alive) in the absence of motility (movement).

XY Ratio Stain

A specialized process is utilized to determine the ratio between male (Y) and female (X) sperm. This gives info that is clinical useful for gender pre-selection (sex selection).

High-speed Centrifugation

When sperm is not seen in the ejaculate, the specimen is spun down in a centrifuge to look for the presence of even a few sperm. Any sperm found are potentially useful for IVF and can bring new hope for couples. Many labs do not even offer this service. It is performed on every specimen processed in our lab.

Sperm DNA Integrity Analysis (aka SCSA)

This test looks inside the sperm on how well the DNA holds together after an external forces applied. If the DNA fragments easily, it has been associated with recurrent miscarriage.

Sperm Penetration Assay (SPA)

SPA tests whether a man’s sperm can penetrate a female egg. Penetration of the egg is required for fertilization to take place. This test is often ordered when low fertilization rates are encountered in IVF without other explanation.