Why Get a Semen Analysis?

For half of all couples who struggle to get pregnant, sperm quantity or quality is at least part of the cause. Despite how common it is, sperm health can be a tough subject to navigate for yourself or with a partner. Because of stigma and a lack of awareness, it’s often overlooked, especially at the beginning of the journey towards conception. 

Luckily, understanding sperm health—or ruling it out as a contributing factor— is pretty straightforward. That’s where a semen analysis comes in. With a semen sample in hand (no pun intended), a certified lab can perform a variety of tests and produce valuable insight into the sperm side of a couple’s equation. Let’s explore test types, treatments that may be available, and ways to navigate male fertility test results.

Sperm: so much more than just count.

To  understand what sperm tests will tell you, start by considering that sperm have to travel from the penis, up the vaginal canal, past the cervix, through the uterus, and down the fallopian tubes to find an egg to fertilize. It’s a long journey, and once a sperm reaches an egg it still needs to have enough energy to fertilize it. 

To make this epic journey, sperm need to be well-shaped and strong, fast, and numerous—because only a very few will survive all the way to the end. Scientifically these attributes are referred to as morphology (shape), motility (movement), and count. There are other metrics too, but we’ll get to those.

Each sperm is one male reproductive cell, composed of two parts: the head (which contains the enzymes used to penetrate the egg, and the DNA which will eventually combine with the DNA in the egg), and the tail (which helps propel the sperm through the female reproductive tract and into the egg, commonly referred to as “swimming”).1 Sperm are created in the testicles and, on their way to ejaculation, are mixed with a fructose-rich liquid produced in the seminal vesicles (a.k.a. semen) which helps provide sperm with the energy required to complete the journey. Semen provides nutrients and creates a protective barrier against the acidity of the vagina.2 Approx. 300-400 million sperm are released each ejaculation in a healthy person.3

#SpermStat: sperm only make up approx. 5% of the total volume of semen – this is why people who’ve had vasectomies generally do not experience any change in the volume of their ejaculate.

Upon ejaculation, sperm are propelled from the penis into the vaginal canal, and their long journey to find a potential mate (er, egg) begins.

Ok, back to our swimmers.

The fastest sperm can reach the fallopian tubes in just a few minutes, while others can take a few hours.5 This journey is not without risks. Of the approximately 300 million sperm that are ejaculated, only a few thousand reach the fallopian tubes, and only one may penetrate an egg (and, of course, sometimes zero sperm penetrate an egg). What happens to the rest? They may be attacked by cells in the female immune system, swim into the wrong ovary (typically only one ovary ovulates per menstrual cycle), or encounter various dead ends in the uterus wall along the way.6

After an egg is released from the ovary, it has 24 hours in which it can meet a sperm. Sperm can live for up to 5 days in the female reproductive system before this meeting, just waiting. Crazy right? After ovulation, an egg produces progesterone, which acts like a homing beacon to the sperm through a process known as chemotaxis. At this point the sperm becomes hyper-activated (yes, that’s a technical term!).7 In a hyper-activated state, the tail of the sperm starts rapidly moving back and forth to give it a surge of energy to close that final gap between itself and the egg. 

Once contact is made, the “acrosome reaction” occurs, in which the sperm’s head acts as a key to unlock the outer layer of the egg, and causes a reaction to prevent other sperm cells from being able to penetrate the egg. Then, the nucleus of the sperm fuses with the nucleus of the egg, forming one complete cell—the beginnings of a an embryo.8 

All about the info, baby.

With all that in mind, you’re ready to understand what a sperm test is actually for. A sperm test, or semen analysis, is a quick, painless (and that’s putting it mildly, considering that an orgasm is usually required) process whereby a lab can see how a person’s swimmers are swimming. While all semen analyses are more straightforward than blood testing or other assessments, not all semen analyses are created equal. 

First of all, most semen analyses require you to make an appointment at a lab, show up, and masturbate on demand. While some clinics and labs have specific, private rooms, others just make you use the bathroom. Even in the best of circumstances, you’re showing up at someone’s workplace and then handing a cup full of semen to a stranger, often in front of others. Not ideal. That’s a huge reason why we partner with Fellow, which allows you to produce a sample at home and mail it in. 

Secondly, you’ll want to ensure that you’re choosing a sperm test that measures all of the important dimensions of sperm health. Count isn’t enough, because if none of the sperm in a semen sample are swimming properly, or if they are all misshapen and therefore unable to complete the journey, then count doesn’t really help you understand fertility. On the other hand, too fewincredibly fitsperm are just as unlikely to lead to conception, because the odds are stacked so heavily against them. Here are the metrics you should make sure a sperm test takes into account:

Motility: How are the sperm swimming? Do they have the strength they need to make it all the way to an egg?

Morphology: How are the sperm shaped? Sperm need to be well-shaped in order to fertilize the egg.

Count: How many millions of sperm are in a sample? And what’s the concentration (count dived by the volume of a sample?

Functional sperm count: Just because a sperm is well-shaped doesn’t mean it is also motile (and vice-versa). A ratio of healthy sperm to not-healthy sperm, which takes into account motility and morphology, will give you a true understanding of the number of viable sperm cells that your man produces.

Volume of ejaculate: This nutrient-rich liquid helps the sperm on their journey.

Certain tests may add on more dimensions to their sperm analysis, and that’s fine. But ensure that any sperm test that you select measures ALL of these aspects, otherwise you may get an incomplete picture of your partner’s reproductive health. Fellow has these metrics covered, so if you choose to test with them you and your doctor will have all the information you are likely to need.

Whether you’re planning to test with a mail-in kit like Fellow or at a clinic, chances are that you’ll be asked to:

• Not ejaculate for 48 hours before collecting a sample (without waiting longer than 5 days).
• Not use lube, lotion, soap, saliva, or any other aids (they can contaminate samples).
• Not be sick (fevers and infections can impair sperm characteristics and will lead to an incorrect reading).

The results are in. Now what?

Everything come back normal? Great! Female fertility assessment, cycle tracking, timed intercourse, supplements, and more are all in play. 

If something unexpected is revealed with the results of a semen analysis, it’s not usually the end of the road. There are proven lifestyle changes and some medical interventions that that can help to increase sperm health and quality or treat infertility. 

The information we provide does not constitute medical advice. You should make all reproductive health decisions with a medical professional.

1:https://www.britannica.com/science/sperm/

2:http://www.my.clevelandclinic.org/health/articles/9117-male-reproductive-system

3:https://www.britannica.com/science/sperm/

4:https://www.britannica.com/science/sperm/

5:https://academic.oup.com/humupd/article/12/1/23/607817

6:https://academic.oup.com/humupd/article/12/1/23/607817

7:https://www.ncbi.nlm.nih.gov/pubmed/22163296