Semen Analysis General Information

A period of 2-3 days of ejaculatory abstinence (either through sexual intercourse or masturbation) is required before producing a sample for analysis. If ejaculation has occurred more recently the sperm concentration may be artificially low. In contrast, if the abstinence period is greater than 5 days the quality of the sample may be affected. The sample that you produce in the special collection rooms at the DSL is immediately placed in an incubator.

Semen Analysis (Sperm Count) A semen analysis is the primary laboratory test for assessment of male fertility. The Diagnostic Semen Laboratory performs analysis using the World Health Organization (WHO) guidelines. From the WHO standards a series of “normal” parameters have been determined as below.

The semen analysis includes assessment of the following:

Ejaculated Volume – ejaculate volume between 2-5 milliliters

Sperm Concentration – greater than 20 Million sperm/milliliter

Sperm Motility – the number and quality of the sperm movement graded as rapid progressive, slow progressive, non-progressive and immotile. Normal motility is when at least 50% of the sperm exhibit rapid or slow progressive movement immediately after the sample liquefies and that movement is sustained for at least 180 minutes.

Sperm Vitality – determines the number of living sperm in a sample. At least 50% of the ejaculated sperm should be alive.

Sperm Morphology – an assessment of the “appearance” of individual sperm. The physical appearance of sperm is assessed with respect to the head and tail characteristics. At least 15% of the sperm should be normal by the WHO criteria used at the DSL.

Leucocyte (white blood cell) count – the number of white blood cells in a specimen. High numbers of white blood cells may indicate infection.

Microbiological testing – the semen may be cultured to identify infections of the semen.

Immunologic Testing (Antisperm Antibody Test)

Assessment for the presence of antisperm antibodies that may impair the movement and/or fertilizing ability of the sperm. Under normal circumstances sperm develops in the testes and are completely isolated from the circulatory system (via a blood/testes barrier). If there is a break in this barrier for any reason surface antigens on the sperm can cause the immune system to develop antibodies against the sperm. Antibodies are common following vasectomy or vasectomy reversal and may impair fertility.

Sperm Wash/Intrauterine Insemination

Intrauterine insemination (IUI) involves the placement of “washed” sperm (partner or donor sperm) into the uterine cavity prior to ovulation. The chance for conception is increased by placing a large number of motile sperm high in the uterus. The sample for IUI is collected by masturbation at the DSL the morning of the insemination procedure. Approximately 2 hours are required to perform the "sperm wash". Clomiphene Citrate IUI / Superovulation IUI)

Sperm Evaluation for IUI

Not all semen samples are suitable for IUI treatments. Samples with reduced concentration, decreased motility or the presence of antisperm antibodies may not be retrieved in the “sperm wash”. An IUI evaluation may be advised prior to starting treatment to determine the suitability of a man’s sample for IUI.

Preparation of Sperm Samples from PESA, MESA, TESE, Vibrostimulation, and Electroejaculation/cryopreservation

This option is available for patients wishing to store sperm for future use include those men having radiation, chemotherapy or other treatments that may render them infertile. Sperm samples obtained through masturbation, PESA, MESA, TESE, as well as vibrostimulation and electroejaculation can be processed and cryopreserved (frozen) and stored indefinitely for future use. Service members serving in war zones may wish to store sperm samples prior to their deployment for future use. Cryopreservation and storage of sperm is not paid for by the provincial health care plans and patients using this service will incur initial and annual charges.

The Procedure of Cryopreservation

Samples are assessed for motility and concentration prior to freezing. The sample is mixed with a biocompatible cryoprotectant and frozen in small straws. The straws are frozen in liquid nitrogen. A portion of the frozen sample may be thawed and examined to assess the post-freeze viability and mobility of the sample.

Due to the nature of the sperm freezing it is usual for motility and concentration to be less after freezing and thawing than in the original fresh sample. Therefore there can be no guarantee that the frozen sperm will be suitable for future use. Once frozen the sample may be kept indefinitely. The majority of degradation of the sperm quality occurs at the time of the freeze, not during storage.

Donor Sperm Bank

The DSL purchases sperm samples from three sperm banks in North America. These include Xytex Corporation (Georgia, USA), Repromed Ltd. (Toronto, Canada) and CanAm Cryo (Virginia, USA). The use of donor sperm for fertility treatments is regulated by Health Canada. All Canadian sperm banks and clinics using donor sperm are inspected by Health Canada to ensure compliance with federal regulations. The staff at the DSL will assist patients in the donor selection process.

Y-Chromosome Microdeletions

Deletions of small amounts of genetic information from the long arm of the Y chromosome may be found in 10-15 percent of men with no or very few sperm. These microdeletions are too small to be detected by normal karyotyping and must be tested for in special labs. The deletion of genes from the Y chromosome may significantly affect the production of sperm. Microdeletion test results are used to predict the likelihood of success of finding sperm from testicular biopsies. This assay is performed on a blood sample from the male partner.

DNA Sperm Fragmentation Analysis

It is thought that sperm with a high proportion of fragmented DNA have a reduced capability to fertilize an egg. Patients that have had failed fertilization or had excessive fragmentation of their embryos in a previous in vitro fertilization cycle may consider utilizing sperm DNA testing to detect this potential problem. The semen samples are flash frozen in liquid nitrogen and sent to a special lab for analysis. A percentage score is generated from the assay with lower percentage scores indicating more favorable fertilization potential.