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Analyzing the semen quality prior to conducting female fertility tests is convenient, non-invasive and cost effective. In fact clinical motivation for assessing semen quality is that it can identify a possible cause of infertility non-invasively and may aid in the prognosis of the therapeutic options the couple have.
Generally one finds a large variation in semen quality, since it is influenced by the days of sexual abstinence and the extent of sexual excitement. It is therefore highly recommended that two or more ejaculates are analyzed prior to truly identify the semen quality.
For practical reasons, at least two ejaculates should be analyzed and if either one of them has poor quality, then additional ejaculates should be analyzed to confirm the findings.
An ejaculate should be collected after two to three days of sexual abstinence. Most of the established sperm quality estimates are based on this time period.
If quality is acceptable, then a second ejaculate should be analyzed after a sexual abstinence period corresponding to the couple’s usual coital frequency, thereby obtaining a realistic assessment of typical semen quality for that procreation couple.
Semen collection through masturbation is the most recommended method.
The semen quality assessment may identify which sperm parameter is affected that is directly related to the corresponding activity within the women’s reproductive system.
For a sperm to reach the fertilization site, it must first penetrate and migrate through cervical mucus in sufficient numbers. This is achieved if the sperm are motile, with normal size and shape (morphology) and have more than a minimum number of sperm determined by routine semen analysis.
The sperm then have to undergo certain changes in their outer membrane prior to fertilizing an egg. This is achieved if the sperm have a functional membrane determined by a sperm fertility test such as the hypo-osmotic swelling test.
If these tests reveal inadequate semen quality, then a test that may identify why the quality is inadequate should be employed.
If sperm motility is affected, then it may be due to an asymptomatic infection or due to immunological factors.
If sperm concentration and or morphology is affected it may be due to inherent or clinical conditions determined by microdeletions in the Y-Chromosome.
If however, the couple is experiencing unexplained infertility, then a sperm DNA integrity and maturity may need to be assessed.
To significantly improve the chances of high number of quality sperm at the site of fertilization, semen may be processed to concentrate all viable sperm into a volume adequate for intra uterine insemination. Patients who desire to influence the gender of their offspring may have their ejaculate processed by gender selective sperm separation.
Also patients prior to chemo- or radiotherapy, prior to vasectomy or prior to medically assisted reproduction should consider cryopreservation of their ejaculate.