Semen Analysis: Tests for Male Infertility

When couples are struggling to become pregnant, they are more than likely to suspect that the cause of the problem is a female reproductive disorder. However, their inability to conceive may actually be due to a medical disorder found with the father. More than one-third of couples dealing with infertility have been diagnosed with a problem with the man’s sperm or semen. With such a high incidence, it makes sense to conduct a semen analysis to identify the problem.

Semen analysis, which measures such characteristics as sperm count, seminal volume, motility, morphology, and several others, is useful for determining how healthy a man’s sperm is. Knowing the health of the sperm is indispensable for couples trying to identify the primary cause of their infertility, and estimate their success rates for future assisted reproduction techniques and related measures.

Among the procedures that comprise semen analysis are the following laboratory tests:
• Sperm Count: Pregnancy rates can vary depending on the sperm count of the male partner. Normal sperm count values would number over 15 million spermatozoa per milliliter.

• Sperm Morphology: According to criteria defined by the World Health Organization, a normal semen sample would have 4 percent or more sperm with a normal morphology. Abnormal sperm would have deranged features such as anomalies in head size, condensed acrosome, doubled tails, doubled heads, or an abnormal middle piece.

• Sperm Agglutination: This is a microscopic examination that checks for any clumping of sperm cells. Agglutinated sperm have a tendency to attach to each other at either end—that is, with heads or tails attached. This results in the sperm cells’ difficulty swimming across the cervical mucus plug that separates the vaginal canal from the uterus. If sperm cannot cross this barrier, they will never reach the egg, and fertilization does not occur. Sperm agglutination can be identified in males with a history of hypersensitivity, infection, or other signs of inflammation.

• Hypo-osmotic Swelling: This examination determines the health of the sperm cells’ tails, which can be useful in determining the ability of the sperm to penetrate an egg. The sperm cells are immersed in a solution of sugar and salt, causing the tails of healthy sperm to swell. Tails of healthy sperm or dead sperm do not change when immersed in the solution.

• Acrosome Test: The acrosome reaction is a cascade of biochemical reactions that occur spontaneously when a sperm cell comes in contact with an egg. Allowing the sperm cells to dissolve the tough outer layer of the ovum in order to pass through.

• Hemizona Assay: In hemizona assay, a human egg cell is bisected, and the sperm cells must penetrate the zona pellucida. This layer is the most difficult layer for sperm cells to breach. The sperm cells that are able to pass through successfully are counted. Only half of an egg cell is used in this examination, hence fertilization does not occur.