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Semen Analysis

All the investigations of the male are based on assessment of the production of adequate numbers of good quality sperm. Several tests may be carried out to achieve this including:

Semen analysis

This is the most common test and every male patient will be required to have at least one of these. It will usually be carried out in the early stages of investigations. It can be an embarrassing procedure for many men but it is an absolutely essential test and treatment will not go ahead unless all requested semen analyses are carried out.

The test includes a sperm count as well as a detailed look at the shape (morphology) of the sperm and the speed at which they are swimming (motility). The semen may also be tested to see if it contains antibodies if this is thought necessary.

A sperm count greater than 20 million/ml with 25% rapidly progressing sperm and 15% morphologically ideal sperm is considered normal.

The swim-up test

This is basically a test of the swimming ability (motility) and fitness of the sperm. It is usually carried out in conjunction with a semen analysis and involves the washing of sperm in a special liquid or culture media and then a measurement of their ability to swim-up into a fresh layer of media. (see diagrams).

This test gives an indication of the ability of the sperm to reach the egg under normal conditions.

• A swim up of 8million/ml with 90% rapidly progressing sperm and 15% ideal forms is our criteria for IUI treatment.
• A swim-up of 4 million/ml rapidly motile sperm but less than 8 million/ml may be best treated with IVF.
• A swim-up of less than 4 million/ml progressively motile sperm is usually best treated by ICSI (Intracytoplasmic Sperm Injection).

The sperm morphology is also considered carefully when deciding on the most appropriate treatment.

Blood tests

It may be necessary to assess levels of the hormones FSH and testosterone if you are found to have a very low sperm count. This test tells us whether you have a blockage or your testicles are failing to produce sperm.

Ultrasound scan

An ultrasound scan of the scrotum can detect problems such as varicocele (varicose veins on the testicles) and hydrocele (liquid filled cysts on the testicles) which can affect sperm quality.