Male Fertility Clinic, Harley Street

About male infertility

The World Health Organisation provides a definition of a 'normal' sperm count:

the concentration of spermatozoa should be at least 20 million per ml.

the total volume of semen should be at least 2ml.

the total number of spermatozoa in the ejaculate should be at least 40 million.

at least 75 per cent of the spermatozoa should be alive (it is normal for up to 25 per cent to be dead).

at least 30 per cent of the spermatozoa should be of normal shape and form.

at least 25 per cent of the spermatozoa should be swimming with rapid forward movement.

at least 50 per cent of the spermatozoa should be swimming forward, even if only sluggishly.

It is clear therefore that in general, 3 inidicators are important in sperm quality. They are sperm count, motility (being active) and morphology (in good shapes). A basic sperm test should give results on the 3 common indicators. An individual may have problem in one dimension only. More often than not, he may have problems in all three in varying degrees. A simple multiplication is usually applied on the three to arrive at one figurere giving an overall picture of how 'good' the sperm are. As sperm perfromance varies over time, it is advisable to obtain more than one test to obtian the average for a more reliable result.

ABOUT SEMEN ANALYSIS

A standard semen analysis will look at three parameters: Sperm concentration, sperm motility and sperm morphology.

Sperm concentration

This is simply the number of sperm cells present in a semen sample. The outcome is express in ml. There can be enormous variation in sperm count in an individual, even over a few days. It is important that at least two samples are analysed, each at least two to three weeks apart.

Sperm Motility

Motility refers to the number of motile sperm cells in a semen sample. The result i.e. number of motile cells is expressed as a percentage of the total number of spermatozoa counted. In addition, the progression of the cells are classified as follows:

(a) Rapid progressive motility
(b) Slow progressive motility
(c) Non-progressive
(d) Immotile

Sperm morphology

Sperm cell morphology refers to the shape of sperm and is carried out by assessing the cells taking each segment (head, neck, midpiece & tail) into cognizance. The sperm morphology count is referred to as the percentage of normal forms. The numbers of morphologically normal sperm cells are expressed as a percentage of the total number of spermatozoa analysed in the morphology count. The abnormal cells are further classified based on the affected segment i.e. head defects, mid-piece defects, and tail defects. Sperm cells with cytoplasmic droplets are also counted and the number expressed as a percentage.