about sperm counts, motility, morphology, DNA fragmentation, aneuploidy & more…

what is sperm count? 

  • sperm count is also called sperm concentration, it is measured as how many million sperm are present

  • 15 million per ml or more is considered fertile

  • 39 million per ejaculate or more is considered fertile

what is sperm motility?

  • motility is how good the sperm are at swimming

  • measurements look at how many sperm are swimming (total motility) and whether they swim efficiently in a specific direction (progressive motility)

  • total motility of 40% or more is considered fertile, this includes both

    • progressive motility - sperm are actively swimming in a line or large circle - 32% or more is considered fertile

    • non-progressive motility - movement without progress, for example swimming in small circles

what is sperm morphology?

  • morphology is the shape of the sperm

  • a minimum of 4% of the sperm need to be of a normal shape to be considered fertile (WHO guidelines)

  • abnormal shapes in the head of the sperm make it harder for it to penetrate the egg

  • abnormal shapes in the tail of the sperm make it harder for the sperm to swim

  • sperm with normal morphology of less than 4% is likely to need help with IVF using ICSI, where the sperm is injected into the egg

  • morphology isn’t measured by the home test kits but it is a frequent cause of male infertility, a laboratory test is needed to assess it

why you should have more than one semen analysis

  • 1 sperm analysis can give false abnormal results of 10% (NICE guidelines)

  • 2 sperm analyses (which need to be 3 months apart) reduces the risk of false reporting to 2%  

  • the guidelines state that false abnormal results are more likely to occur than false normal - so if your result is normal there is no need to repeat. 

what is MAR and what are anti-sperm antibodies?

  • some laboratories will also give a result for MAR IgA and IgG

  • this stands for Mixed Antiglobulin Reaction and looks for the presence of proteins called immunoglobin A and G. 

  • a positive test indicates the presence of anti-sperm antibodies which can affect the sperm's ability to penetrate cervical mucous and fertilise the egg. 

  • anti-sperm antibodies are an immune reaction which sometimes happens when there has been a history of inflammation, infection, injury or surgery to the testes

what can I do if my sperm count is abnormal?

  • mild abnormalities may respond to changes in lifestyle and diet

  • seeing a specialist - a fertility urologist may help define the problem and find treatment solutions

  • IVF with ICSI may be indicated

what is DNA fragmentation in sperm?

DNA fragmentation is an additional test which tells us what percentage of the sperm have some DNA damage - this is measured as a DNA fragmentation index

  • 15% or less is good to excellent

  • If above 25% show damage then IVF with ICSI would be recommended

  • 50% or more shows very poor DNA integrity

  • DNA fragmentation has been linked to increasing age and lower progressive sperm motility in both fertile and infertile men (Das et al. 2013)

  • 11% of men with normal sperm and 5% of men with high normal or ‘super’ sperm had elevated DNA fragmentation (Belloc et al. 2014)

  • more detailed information available here

what is oxidative stress in sperm?

  • oxidative stress is an additional test and is measured as Reactive Oxygen Species (ROS)

  • it can affect both sperm quality and function, current thinking is that sperm abnormalities at a molecular level (which don't show on routine sperm counts) may contribute to 25% of cases of unexplained infertility. If oxidative stress levels are shown to be high then anti-oxidant supplements may be indicated

  • more detailed information available here

what is sperm aneuploidy?

  • this examines the sperm for chromosome defects

  • up to 13% of sperm with defects is considered normal, but higher percentages may affect conception or recurrent miscarriage risk

  • the test is limited to specific chromosomes so may not pick up all defects

  • chromosome defects in sperm increase with age, lifestyle factors such as alcohol, smoking, caffeine and environmental pollutants, and some medicines. 

  • checking the sperm chromosomes can be done in addition to checking the blood karyotypes as some types of abnormalities relating to cell division only show in the sperm.

comprehensive semen analysis test

The Doctors Laboratory in London offer a Comprehensive Semen Analysis and this includes count, motility, morphology, and MAR. 

  • more detailed information is available here 

  • you can make an appointment online but you will need a referral form for the test