Trying to Conceive: Testing Semen for Infertility
Coagulation and liquification:
The consistency of the semen can help diagnose certain issues when you're trying to conceive. If it doesn't coagulate when he ejaculates, there could be an issue with the seminal vesicles. If it doesn't turn back into a liquid about 30 minutes after ejaculation, that could be a sign that there's a problem with the prostate.
Color and appearance:
Normal, healthy semen is usually a whitish-grey color upon ejaculation and translucent when it re-liquifies (about 30 minutes later). If it's a yellow color, that could be a sign of infection; a reddish or brownish tint may mean there's blood in the semen.
Icky, unpleasant smelling semen may indicate infection. If there's no scent at all, that could mean a prostate problem.
The average amount of ejaculate is 2 to 5 milliliters (about one-half to a full teaspoonful). Too little might mean that some of the semen ejaculated backward toward to the bladder, that the seminal vesicles are missing, that there's an obstruction somewhere, that there's an issue with semen production or that the man has ejaculated too frequently. On the other hand, too much semen might mean a problem caused by overactivity of the seminal or prostate glands, which affects the quality and motility of the sperm when you're trying to conceive.
The normal pH for semen ranges from 7.2 to 7.8. If the pH level is too high or too low, the prostate or seminal vesicles may be infected or inflamed.
This test helps determine whether or not there is an infection present. If the sample is too thick and sticky, antibiotics may be prescribed.
This is the hardest test to nail down. There can be substantial variation between lab technicians' reading of the same semen specimen and also from one semen sample to the next. So, it's fairly common to check to or three samples to get an accurate reading when you're trying to conceive. The average sperm count for healthy, fertile men is anywhere between 40 and 120 million per milliliter. The World Health Organization (WHO) defines a normal sperm concentration as 20 million per milliliter or more.
Just how strong are his swimmers? This test will tell. Semen is rated on both the percentage of sperm that are moving (for example, 50 percent to 60 percent) and how well they move (usually on a scale of one to four; with grade two or better considered normal).
Yes, sperm come in all shapes and sizes. But generally, a healthy, mature sperm has an oval head, a cylindrical middle, and a long, tapering tail. If more than half of the sperm are abnormal, there may be a fertility problem.
The tech will check to see if the sperm clump together, which could be a sign or either infection or that there are antibodies in the sperm. The antibodies stop the sperm from swimming.
The sample will be cultured and checked for bacteria and sexually transmitted diseases such as chlamydia, gonorrhea, HIV, and more if infection is suspected.
If the doctor suspects the sperm is having difficulty penetrating his partner's cervical mucus when you're trying to conceive, she'll order this test (it's also called a sperm invasion test). A column of cervical mucus from a cow is placed into a reservoir of sperm. The idea of the test is to see how well the sperm can make it through the mucus.
Crossover sperm invasion test:
This test is performed when there's reason to suspect that there's a problem with one partner or another, but it isn't clear whom. In this case, the male partner's sperm is combined with the egg of a donor female, and the female partner's egg is fertilized with semen from a donor male. The results can help to determine where the fertility problem lies.
Hamster egg penetration test:
Although this test sounds like something out of a bad science fiction novel, it's for real. In an egg penetration test—sometimes called a sperm penetration assay—a laboratory technician observes how well the sperm are able to penetrate a hamster egg. Although the test is not standardized from lab to lab and its usefulness is widely debated, it may help to identify sperm abnormalities not revealed by the usual measures of count, motility and morphology in couples with unexplained infertility. It also may be useful in assessing the effects of various sperm treatments and as a preparatory step for in vitro fertilization.