July 6, 2021 | By: Steph Kagan, Nurse Practitioner
Did you know that about 35 percent of infertility is related to or includes male factor infertility? Also, about 10% is strictly due to male factor, meaning the sperm is the reason conception has not occurred.
Why a Semen Analysis?
The TTC journey is quite challenging for a variety of reasons, emotionally, physically and financially. One of the reasons we like to encourage a semen analysis after a couple months without pregnancy is to make sure we are making the best use of your time and efforts.
When it comes to the health of the sperm, you could be using your ovulation tests perfectly, having a beautiful LH surge and great BBT rise, but if the sperm is impacted, your chance of pregnancy can be drastically reduced. It is always best to rule out the possibility of the sperm being an issue, or on the contrary – finding a variable that could be the reason why it is taking longer than expected.
Sperm formation takes about 74 days from start to finish and then approximately 12-21 days for transport. This means that the last three months are imperative to the current quality and concentration of the sperm. It is important to know that prior pregnancies years ago unfortunately do not ensure that the sperm is still healthy and able to create a normal embryo.
What Are Signs of Unhealthy Sperm?
Let's chat about the regular parameters that are the keys to the overall interpretation. They include: volume, concentration, motility and morphology. Volume is the overall amount collected when analyzed and the normal range is 1.5 mL to 6.0 mL. Concentration is the amount of sperm per mL. This should be higher than 15 million per mL. Motility looks at how the sperm are moving, whether they are swimming fast or slow, straight or in a circle. This should be greater than 40%. Morphology is a strict analysis of the head shape of the sperm, referred to as a Krueger analysis. This is key to understanding the health and ability of the sperm to fertilize an egg and should be greater than 3%. For further details, check out our article on Testing for Male Infertility.
What Are the Signs of Infertility in Males?
When these numbers are low, the best thing to do is to see a urologist to help understand why. Factors that can impact the overall sperm quality include recent illness or fever (in the three months prior generally) and medication use (taking testosterone kills sperm and many hair growth products are not safe for sperm health). Lifestyle factors such as smoking, hydration status and weight also have a role. Also important is medical history, which would include chemotherapy, varicocele repair, trauma to the testicles and evaluation for abnormalities of the tubules that transport the sperm. Lastly, genetic abnormalities and hormonal imbalances in men can have a great impact on sperm health.
How to Increase Your Chances of Getting Pregnant
So what can you do now to help improve overall sperm health? First, get a formal semen analysis in order to understand the full picture! These can be ordered by your primary care provider, or a referral can be given for your partner by your OB/GYN. Many fertility clinics also have “community days” where you can get an analysis done without having to be an active patient at the fertility clinic.
If you and your partner have been trying to conceive for a few months without luck, this is a great place to start because there is no “wait time” to have one of these done: you do not have to wait a year or six months, and this can be completed at the time of your choosing.
From a personal perspective, starting a healthy non-processed diet can limit the exposure to toxins. The most frequently abnormal parameter is the last one, morphology. When this is low it is called teratospermia and is most commonly impacted by environmental factors around us. Taking a high quality fish oil and consuming a serving of walnuts daily is a great place to start to combat the everyday toxins we encounter. Remove any factors such as smoking or vaping, excessive alcohol intake and try to limit daily stress. Make sure hydration is adequate, which can improve the amount of seminal fluid and overall volume. Note: newer studies are showing that the type of underwear worn by men does not appear to impact overall fertility and should not be considered as a limiting factor.
Also, keep tracking your own symptoms with Premom, the free ovulation tracker app. As soon as you have the results to your semen analysis, add the notes to your app as another useful reference for a virtual consultation with one of our Premom providers and/or your OB/GYN.
Steph has been a women's health nurse practitioner for 5 years and has worked directly in the field of reproductive medicine. She is board-certified, personally brought nutrition consults to the private practice she was working for, and studied the impact of nutrition on reproductive health. Steph has been helping women conceive for years at the bedside in a clinical setting and brings a positive, optimistic outlook to challenges that couples may be facing, whether it is their first baby or a goal to complete their family. Schedule a consultation with Steph Kagan right through your Premom app!
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Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol 2014; 30:2.
Pinilla L, Aguilar E, Dieguez C, et al. Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Physiol Rev 2012; 92:1235.