Production of semen samples
Semen samples should be produced by masturbation at the Centre so that the analysis can take place immediately after production. However, if you feel you are unable to produce a sample on-site, please speak to one of our laboratory staff to discuss alternative arrangements.
Please make sure that you do not ejaculate for 3 days prior to producing a semen sample for analysis. This is important as it will ensure that the sample you produce on the day is at its optimum in terms of numbers and quality.
The results of your semen analysis will be available after three days and will be discussed with you by your consultant. We do not give results out over the telephone, although you may request a written report.
The following will be assessed during the semen analysis: the number of sperm present within the ejaculate (the sperm count); the number of sperm that are moving (the motility); the number of sperm that are normally formed (the morphology) and whether or not there is any infection present within the sample.
What is a 'normal' semen analysis result?
A normal semen analysis will show the following: a semen volume of between 2 and 3mls; a sperm count of at least 20 million sperm per ml; at least 45% of the sperm will be motile; at least 30% of the sperm will be normally formed and less than 10% of the sperm will be affected by antisperm antibodies.
The degree of variance from these accepted normal values will be assessed and the implications explained by your consultant during a follow-up consultation.
Hormone Assessment of the Male
In cases of azoospermia, blood analysis of hormones (FSH, LH and testosterone) will be taken. This will tell us if there is a blockage or if there is no sperm production within the testis. ~50% of the cases, Testicular Sperm Extraction (TESA) will retrieve enough sperm to fertilize the egg. Exceptionally if the levels of testosterone are too low, in the most severe cases hormone replacement therapy will be advised.
- Consulting men for urination, erection, fertility problems
- Assays kidney, phallus, prostate, urinary bladder, sperm
- Urinary diseases treatment
- Kidney, bladder
- Prostate ultrasonography, residual urine measurement
- Testicular ultrasonography.
Transrectal prostate ultrasound
- Blood test for prostate cancer - PSA
- Blood test for all infertility: LH, FSH. Testosterone.
- Blood investigators. For testicular cancer all: AFP, beta HCG, LDH
Causes of male infertility can be divided into three main categories:
1. Sperm production disorders affecting the quality and/or the quantity of sperm
- Affected by the raised local (scrotal) temperature,
- Presence of varicocele,
- Use of tight under-garments,
- An occupational hazard where men are subjected to excessive hea
- Incomplete development of testis.
- Late descent or non-descent of the testis
- Obstructions can be due to
- Absence of the tract (vas) from birth.
3. Other factors such immunological disorders
Approximately a third of all cases of male infertility can be attributed to immune or endocrine problems, as well as to a failure of the testes to respond to the hormonal stimulation triggering sperm production. However, in a great number of cases of male infertility due to inadequate spermatogenesis (sperm production) or sperm defects, the origin of the problem remains unexplained.
- Any evidence of previous surgical scars in the groin or scrotal areas;
- Assessment of the development of the penis should follow, together with assessing whether the testes are present in the scrotum;
- Careful examination of the testes must take place, including a measurement of their size and texture.
- The epididymis is carefully examined to determine whether it is enlarged, whether there is evidence of lumpy growths ('cysts') and whether the vas deferens can be felt;
- The blood vessels entering the testis at the top of the scrotum should be examined both with the man lying down and standing up, which is one of the best ways to determine whether or not a varicocele is present;
- If there is any suggestion of inflammation of the prostate gland, a rectal examination of the prostate should be undertaken.