Infertility is one of the major challenges many couples face on their path to starting a family. While numerous factors can contribute to infertility, evaluating male reproductive health is an essential part of the diagnostic and treatment process. One of the most important diagnostic tools in this field is semen analysis, which provides vital information about the quality and quantity of sperm.
Semen analysis helps doctors identify male factors affecting infertility. By evaluating various semen parameters, including volume, sperm concentration, motility (sperm movement), and morphology (normal sperm shape), this test provides an overall picture of a man’s fertility status. The World Health Organization (WHO) has established guidelines and reference ranges for interpreting the results of this test, which are considered the primary guide for specialists in this field.
Based on the latest WHO guidelines, the decision to repeat a semen analysis depends on the initial results:
If one or more semen parameters are outside the WHO reference ranges: To confirm or refute the initial findings, WHO suggests repeating the semen analysis after a minimum of 11 weeks. This recommendation is based on low-certainty evidence and aims to ascertain the stability or potential change in sperm parameters.
If all semen parameters fall within the WHO reference ranges: In such cases, WHO suggests that the semen analysis should not be repeated, as normal results reduce the likelihood of a sperm-related issue.
The WHO Laboratory Manual for the Examination and Processing of Human Semen is the primary source for understanding semen parameter reference ranges, as well as standard methods for collection and testing. Accuracy in implementing these standards is essential for obtaining reliable semen analysis results.
Unexplained Infertility: When Everything Seems Normal
Sometimes, even when test results appear normal, couples still face difficulties in conceiving. The WHO has defined a condition called ‘unexplained infertility’ where all the following criteria apply:
In such cases, despite normal initial semen analysis results, further investigations or different treatment approaches may be necessary.
Ultimately, semen analysis remains a fundamental basis for evaluating male infertility, and whether it needs to be repeated or not should be based on medical guidelines and initial results.
The evaluation of men is usually much simpler and faster than for women. It is done through a sperm test.
The spermogram test is the first and main step in testing the man for sperm, which includes three main parameters:
1. Sperm Count (Concentration): The number of sperm per milliliter of fluid (less than 15 million per milliliter) is called Oligospermia.
2. Sperm Motility: Sperm movement is essential for reaching the egg. It refers to the percentage of sperm that move forward.
3. Sperm Morphology: The shape of the sperm should be normal (oval head, healthy neck and tail). Abnormal shapes impair the sperm’s ability to enter the egg.
To perform the test, the individual must abstain from ejaculation for 2 to 5 days. Factors such as stress or illness can directly affect sperm quality, and sometimes the individual may need to repeat the test after a few weeks.
Although some people still consider fertility a “women’s issue,” in 20 percent of infertile couples, the problem lies solely with the male partner. Male infertility may be one of the main reasons a couple cannot conceive, or it may simply add to the difficulties caused by infertility in the female partner.
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