Sperm Testing & Semen Analysis: Male Infertility Testing

A semen analysis measures the quality of a man’s semen sample to determine his level of fertility. This test includes a sperm count. According to the latest WHO recommendations, a normal sperm count is 16 million sperm per mL.

In order to analyse your sperm health, a basic semen analysis assesses the following:

• Sperm motility: movement of the sperm (swimming ability).
• Morphology: percentage of sperm that have a normal shape.
• Count: the number of individual sperm present in one ejaculation.

Following your semen assessment, the results may indicate a conservative approach to treatment, such as intrauterine insemination(IUI), whereas a reduction in count or motility may suggest the need for the more advanced technique of IVF. In the most severe cases of male infertility, intracytoplasmic sperm injection ICSI may be recommended.

Male infertility can be caused from a variety of factors including low sperm production or azoospermia which is no sperm, poor quality sperm, issues with sperm delivery, as well as illness, injury and overall health. To determine whether a man has a reproductive problem, a semen analysis will be requested. The results are very important in diagnosing male infertility as well as choosing the best fertility treatment for a couple.

Sperm testing is a straightforward test. Your fertility specialist will request that you bring a semen sample, usually collected by masturbation, into the clinic for testing in our andrology labs. No lubricants should be used as they might kill the sperm.

They may also request a blood test to assess for low male sex hormones that can affect fertility. Our scientists will analyse the sperm present in the semen. Depending on these results, your specialist may recommend further tests, including sperm DNA fragmentation, an immunobead test or a testicular biopsy.

To learn more, please read our fact sheet: Semen assessment.

While semen analysis is a first step in assessing male fertility, additional tests may be needed for a more complete picture. More advanced tests may include Sperm DNA fragmentation, Immunobead test to identify sperm antibodies and a testicular biopsy.

Sperm DNA Fragmentation refers to DNA damage within the sperm, which may affect embryo development, reduce implantation and increase the risk of miscarriage.

The DNA integrity of the sperm is essential for healthy embryo development. A high level of fragmentation may reveal an infertility cause that a semen assessment alone won’t detect.

To learn more, please read our Sperm DNA fragmentation fact sheet.

The Immunobead Test, also known as IBT, checks for anti-sperm antibodies. The male immune system sometimes creates anti-sperm antibodies that attack sperm, preventing them from swimming. Besides, production of these antibodies may be triggered by infection, cancer or due to surgery such as a vasectomy. The presence of antibodies can reduce the ability of the sperm to reach the egg, thus reducing or preventing fertilisation.

A testicular biopsy, also known as Testicular Sperm Aspiration (TESA), is a test in which sperm is extracted directly from the testicles and analysed.

A testicular biopsy is performed when the male partner does not have sperm in his seminal fluid. This could be due to several factors, including a vasectomy, failed vasectomy reversal, obstruction, retrograde ejaculation (when sperm is released from the bladder), abnormal anatomy (an absence of vas deferens) or other genetic conditions.

Male infertility affects thirty percent of couples and the good news is that we can easily diagnose this with sperm testing. The results of a semen analysis will allow your fertility specialist to recommend treatment. This may be as simple as making lifestyle changes to more complex treatment including:

Treatments for Male Infertility

• IUI – recommended for patients with normal semen parameters.

• Standard IVF – recommended for patients with normal semen parameters where IUI has been unsuccessful. Your clinician may suggest standard IVF over IUI depending on the female partner’s fertility history.

• ICSI – recommended for patients with reduced semen parameters i.e. count and motility or where standard IVF has been unsuccessful.

• TESA – recommended for patients with no sperm in ejaculate or inability to provide a sample.