Men are just as important in the process of conception as women. According to an article available in the National Library of Medicine, “The male is solely responsible for about 20% and is a contributing factor in another 30% to 40% of all infertility cases.” So how can you know if this may be what’s causing your trying to conceive (TTC) journey detours?
Why a Semen Analysis?
The TTC journey is quite challenging for a variety of reasons. A semen analysis is often a great idea after a few months without pregnancy to ensure there are no male factor issues at play.
Fertility and the likelihood of conception is impacted by many variables, from our age and genetics to our partner’s health and the toxins we are exposed to in our environment. The goal is to understand as many of our personal variables as we can and to work to reduce those that may have a negative impact, or understand those that could be creating the challenge of conception.
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 from years ago do not ensure that the sperm is still healthy and able to create a normal embryo.
What Are Signs of Unhealthy Sperm?
A semen analysis measures three major factors of sperm health:
- The number of sperm – a healthy sperm count is about 15 million or more for every milliliter (mL) of semen (the discharge in a single ejaculation). You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate. Too little sperm in an ejaculation might make it more difficult to get a woman pregnant because there are fewer sperm available to fertilize the egg.
- The shape of the sperm – a normal sperm has a smooth, oval-shape head (5-6 micrometers long and 2.5-3.5 micrometers wide) with a long tail. The head shape is important because it affects the sperm’s ability to dissolve through the outer surface of an egg and fertilize it. The more normal shaped sperm you have, the more likely you are to be fertile.
- Sperm motility – progressive motility refers to sperm that swim in a straight line or in very large circles. Non-progressive motility refers to sperm that move but do not swim in progression or swim in very tight circles. Progressive motility is needed for the sperm to swim their way up the female reproductive tract. You are most likely to be fertile if at least 40% of your sperm are moving progressively.
If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually mean you do not have any significant infertility problems. If something in the results looks unusual, your doctor might order more tests to identify the problem.
What Are the Signs of Infertility in Males?
When these results are abnormal, the best thing to do is to see a urologist to help understand why. Illnesses, injuries, chronic health problems, lifestyle choices, and other factors can play a role in causing male infertility:
Medical Conditions
Varicoceles. One of the most common causes of male infertility. This is swelling of the veins that drain the testicle.
Infections. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV.
Antibodies That Attack Sperm
Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Hormone Imbalances
Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone and other hormonal problems have several possible underlying causes.
Environmental Issues
Being exposed to industrial chemicals, heavy metal exposure, overheating the testicles or radiation on the job, or in and around the home can reduce sperm production. In some cases, it can permanently reduce production.
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 a 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 sperm parameter is morphology. When this is low, it is called teratospermia and is most commonly impacted by environmental factors. Taking a high quality fish oil and consuming a serving of walnuts daily may help 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.
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.
References
- Leslie SW. Male infertility. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK562258/. Published March 3, 2023.
- Jung A, Schuppe HC. Influence of genital heat stress on semen quality in humans. Andrologia 2007; 39:203.
- 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.
