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Can the sperm be abnormal even though the semen analysis is normal?

by - 09.15.2018 | Blog

If you and a partner have been trying to conceive but find yourselves facing difficulties, your doctor might have recommended a semen analysis. A semen analysis uses a number of criteria in order to evaluate male fertility and help determine any potential source of concern that may be causing your fertility struggles. It can sometimes be even more frustrating when the semen analysis comes back normal in this situation, so it’s important to first understand what the analysis looks for.

What Are Normal Results for a Semen Analysis?

There are a number of things that fertility specialists look for in a semen analysis, from fluid thickness to volume of semen and movement of the sperm. Each of these are analyzed and compared to specific criteria to determine whether the sperm are normal or abnormal.

Appearance

When we consider appearance in a semen analysis we take a look at the color. Healthy, normal semen is white or gray with an opalescent sheen. Having a red-brown or yellow tint can indicate infection or a side effect of a medication that may be affecting your ability to conceive.

Liquefaction

Semen starts out thick, but then liquefies in order to help the sperm move through the female’s reproductive system to an egg, where, hopefully, fertilization can occur. If sperm do not liquefy within 45 minutes, it could affect fertility.

pH

The sperm’s pH level can indicate a number of concerns that could be making it more difficult to conceive. To be considered normal, the sperm’s pH level should fall between 7.2 and 7.8. Anything above 8.0 could mean the male has an infection, while anything below 7.0 may be the result of contamination or a sign of blocked ejaculatory ducts.

Movement

Sperm movement, or motility, is measured on a scale from 0 to 4, with 0 signifying that the sperm are not moving and 4 representing good movement. In order to fertilize an egg, sperm must be able to travel; if sperm cannot travel normally, then they will face difficulties making it to and fertilizing an egg. In this analysis, more than 50 percent of sperm must be moving normally an hour following ejaculation in order to be normal. Keep in mind this leaves some room for there to be sperm with poor motility in spite of the majority receiving a normal score.

Sperm Count

Sperm count, or sperm density, is important for conception. Low sperm count introduces a fertility challenge and may require more time or alterative solutions. To be considered normal, sperm count should fall somewhere between 20 million to over 200 million.

Sperm Shape

With sperm shape, it’s important to know that even if the semen analysis results are normal, half of the male’s sperm can still be abnormal. In order to be deemed as normal for the analysis, at least 15 percent of sperm need to appear normally shaped in the head, midsection and tail. More than 85 percent of sperm abnormally shaped reduces the male’s fertility, and may be the source of fertility struggles.

Volume

In a semen analysis a fertility specialist will measure the volume of semen in order to determine whether there is enough semen to fertilize an egg. If volume is low, there is a lower amount of sperm to fertilize an egg, which restricts the ability to conceive. With excess volume, the sperm is diluted. Normal results will result in greater than 2 milliliters of semen.

Semen Analysis Is Normal, But Still Having Fertility Problems?

An uncommon issue with a normal semen analysis may be related to the DNA strength of the sperm. Sperm DNA testing can be useful in such cases and includes few different methods and tests. Sperm DNA fragmentation testing can reveal “quality” issues with the sperm whereas a semen analysis only provides quantitative information.

If sperm DNA fragmentation is high, sperm fertilization capacity and quality may be low which can affect fertility and cause infertility in some cases. An effort should be made to find out about the cause of sperm DNA fragmentation which can be due to high stress, exposures to toxins, environmental variables, presence of a varicocele, and excessive heat exposure to the scrotum or other causes. If there is an identifiable cause, it can be treated and sperm quality improved, which would then improve fertility outcome.

Remember that even with a normal semen analysis you could still have some abnormal sperm in your semen. A normal result simply means that the majority of your sperm are normal in a variety of critical ways, and that’s a great thing when you’re trying to conceive. If, however, you are still having difficulties conceiving, it’s time to talk to the fertility specialists at LA IVF. We can help you find a solution that’s right for you and discuss the possibility of additional testing such as genetic testing, hormone testing or anti-sperm immune cells testing to eliminate other potential sources of concern.