Why Sperm analysis is done?

A sperm analysis is an essential part of the evaluation of an infertile couple. In most cases, this is the only test, a male partner requires. However, a single abnormal semen analysis does not always mean that there is any abnormality in the man.  In a man, sperm production requires 3 months and it needs cool temperature than the rest of the body. This is why men have their testes hanging outside the body in the scrotum. Thus, today's semen analysis reflects a man's health 3 months before. If for any reason (for example, high fever, tight underwear, hot tub bath etc), man's health was abnormal 3 months ago, the semen analysis may become abnormal. Again, the results can vary from one laboratory to another.

Is there any difference between semen and the sperms?

Semen consists of 2 parts- the sperms and the fluid ("seminal plasma"). The sperms cannot be seen by the naked eye. The fluid that you can see, is the semen. So, semen and the sperms are not the same.

How semen is tested?

In the laboratory, semen is tested for certain parameters like- volume (amount of semen), liquefaction (time needed for semen to become liquid), colour, appearance etc.  

The sperms are checked for total count, motility (the ability of the sperms to move), morphology (the appearance of the sperms), vitality (whether sperms are living or not) etc. It is important for the laboratory to follow WHO 2010 criteria for semen analysis (not the older criteria like 1992). Sometimes, some special tests may be done on the semen depending on your scenario. 

How semen collection and analysis is done?

The easiest and the most commonly used method is masturbation. You should collect it in the laboratory in a room with adequate privacy and comfort. Of course, for most of the men, it seems awkward to collect semen in an unfamiliar environment, away from home. Usually, most laboratories provide a separate room where you can bring your partner with you.

Is any preparation required?

Please maintain abstinence for 3 to 5 days (not more than 5, not less than 3). That means you should avoid intercourse and masturbation for 3-5 days prior to the test. This is because both long term (more than a week) and short (less than 2 days) period of abstinence can lead to false results regarding quality and quantity of the sperms. 

Get relaxed. Wash your hands properly before the collection. It's important to collect all the semen in the collection pot and not to spill a portion outside. Do not hesitate to tell your doctor if you feel any problem. 

I feel ashamed to collect sperms in the laboratory. What should I do?

This is particularly embarrassing for many men if you are doing the test for the first time. But remember, this is a commonly performed test in the laboratory. Try to get relaxed. Some men cannot collect semen, just because of mental stress. Avoidance of stress and counselling help many men to overcome this problem.

If your problem during collection is because of problems in erection, some medicine is given to improve your erection. If you have an erection but are unable to ejaculate, Vibro-ejaculator (see below) can help you.

I tried but could not collect sperms in the laboratory. What should I do?

It's preferable to collect semen in the laboratory. But if it’s not possible, you can collect it at home. In that case, you must carry it in the pocket of your trousers and must reach the laboratory within 30 minutes of collection. Please inform the laboratory about the timing of collection.

I have never done masturbation. What should I do?

Do not worry. Some men may have this problem. The options include·        

  • Vibro-ejaculator- a small device applied on the front part of the penis ("Glans Penis") to stimulate the organ to discharge the semen.      
  • Non-Toxic Condom - rubbing the penis against special condom (not ordinary condom).
  • Intercourse- Some men feel comfortable to practise coitus interruptus (withdrawing the penis just before ejaculation) using a non-toxic condom.

I cannot ejaculate even during intercourse. How can I test?

Please inform your doctor. The problem may be due to some previous surgery, neurological problems, spinal cord injury, diseases of prostate or problems since birth. The following methods are useful, not only for testing sperms but can also freeze the sperms for future treatment, if required. 

  • Non-toxic condom- If you have a nocturnal emission (“Nightfall”) you can use this condom over penis while sleeping and collect the semen and carry it to the laboratory. However, all the parameters cannot be tested because of a delay in transport.
  • Vibro-ejaculator- can help in many cases
  • Testing urine- In few men, the problem maybe retrograde ejaculation (Semen going into the bladder instead of moving forward). In that case, sperms can be collected from the urine immediately after masturbation.
  • Prostatic message- If urine test shows no sperms, your doctor can insert lubricated gloved fingers inside your anus to massage your prostate gland, that can help some men to ejaculate.
  • Electroejaculation- If prostatic message also fails, your prostate gland can be stimulated using a small probe inserted through the anus under general anaesthesia.
  • Testicular biopsy- If all of the above methods fail, a needle can be inserted inside the testes (TESA) to check whether sperms are produced inside. If that fails, a small cut is given in an attempt to collect the sperms from the testes (TESE).

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The problem during semen collection is common and many men face it. Fortunately, most of them can overcome this embarrassment by themselves. If you feel any problem, do not hesitate to tell your doctor.