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What Can I Expect from a Semen Analysis? Andrology & Fertility FAQs

Andrology is a critical part of the fertility puzzle, but not well understood. Here's what to expect from a semen analysis and what this test can tell you.

November 21st, 2023 | 9 min. read

By Sierra Dehmler

The andrology wing of a fertility clinic tends to be shrouded in mystery. What exactly goes on behind those closed doors? And what can a semen analysis tell us about a man's fertility?

In this article:

What is andrology?

As a new patient at a fertility clinic, it's easy to get overwhelmed with all of the diagnostic testing and appointments ahead of you. One of the first tests a male partner will undergo is a semen analysis, which will then be evaluated in the Andrology Lab. But what is andrology?

In short, andrology focuses on the reproductive system of anyone assigned male at birth. Andrologists are specially trained to make sure everything involving that system is working properly and effectively, and if not, they work to figure out why.

The Importance of Sperm Health

To quote a favorite metaphor from our Medical Director, Dr. Mark Leondires, "the sperm is the car key that gets everything started."

And while sperm is just one piece of the fertility puzzle, it's a crucial one, so it is important to make sure everything in the male reproductive system is working properly and effectively before attempting to conceive a baby. If for any reason it's not, our team of experts work quickly to figure out why.

We have fully-accredited, in-house andrology laboratories located in each of our five offices in Norwalk, Stamford, Danbury, and Trumbull, CT, and Harrison, NY. This leads to shorter turnaround times for test results, closer collaboration between lab staff and your Illume Care Team, and the ability to closely monitor the quality and safety of lab procedures.  

We reached out to our Andrology Team to get the scoop on some of the most frequently asked questions about male fertility and walk you through what a semen analysis entails. 

What to Expect from a Semen Analysis

For men, fertility pretty much hinges on having healthy sperm, so a semen analysis is the most important test for the male half of a couple that is experiencing fertility issues. Thankfully, it is an inexpensive test that can be performed early on in any infertility evaluation to easily rule out male factor infertility

To demystify the experience, let's tackle some of the most common questions we hear from patients as they prepare for a male fertility evaluation.

Part 1: Your Semen Analysis Appointment

Why are 2-5 days of abstinence needed prior to semen analysis?

A man's body is continuously generating sperm.

Nevertheless, the body also needs time to keep up with demand. Having an abstinence period of less than two days may affect your sperm sample. Coincidently, allowing too much time to pass can also provide undesirable results.

Staying abstinent within the 2-5 day window will provide the best outcome for your semen analysis. We ask that you be mindful of this prior to your scheduled appointment.

What will happen when I arrive at Illume Fertility?

We pride ourselves on providing a professional, comfortable, and smooth experience for all of our patients. When arriving to your semen analysis appointment, our front desk team will check you in and guide you through any necessary paperwork.

One of Illume Fertility's andrologists will then walk you back to the Andrology Laboratory area, which is private and isolated from the rest of the patient care rooms.

What to expect:

The laboratory wing of our practice has individual patient rooms where we will provide you with all the necessary materials to collect your sample. This provides each patient with privacy, while still making it convenient to pass your sample directly to a lab staff member upon completion. The specimen is collected directly into a clean container.

I’m anxious, can my partner come in the room with me?

Absolutely! We just ask that there is no oral sex because saliva does affect the viability of the sperm.

Is the sample I produced large enough?

Yes. We can do a lot with a low volume sample!

On average, less than 50 microliters is needed to perform all the tests in a semen analysis. Having a low volume may affect other procedures such as IUI or cryopreservation. In those instances, a lab technician will make you aware of any additional steps.

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Part 2: Semen Analysis Process & Test Results

What tests are performed during a semen analysis?

There are many different procedures we perform in the Andrology Lab. The most common things we assess or measure are sperm concentration, motility, and total motile sperm (TMS). 

  • Sperm concentration is the number of sperm per milliliter of ejaculate. This is important for your doctor to know so they can make the best decisions about your fertility treatment protocol.
  • Sperm motility correlates to the percentage of the sperm that is moving around or "swimming" normally in the sample.
  • We use these two values in conjunction with the sample’s volume to calculate "total motile sperm" (TMS). This tells us how many moving sperm is in the entire ejaculate sample. This is important for certain decisions made in the laboratory.

What can cause male infertility?

Both morphology and motility are factors in male fertility because they impair the sperm’s ability to reach and fertilize an egg. Some common causes of abnormal morphology are infections, high fever, congenital testicular abnormalities, varicocele (enlarged veins in the scrotum), and drug use.

A urologist can recommend treatments that can improve morphology, including treating an infection, varicocele repair and hormone replacement. Pregnancy may still be possible through intrauterine insemination or in vitro fertilization.

How are semen analysis results interpreted?

Once test results are available, you will be given information about the sperm concentration. This tells us how much sperm is in one milliliter of ejaculate. We will then discuss with you what percentage of the sperm is moving normally (this is described as motility).

Another important test is morphology. Morphology looks at the shape of the sperm as well as identifying key structures and ensuring they are normal. Similar to the other tests we perform, morphology is an important factor in many procedures; especially in the Embryology Laboratory.

Feeling confused? Interpreting these results can be challenging. If you have any questions or concerns, we highly recommend reaching out to the lab staff or one of our nurses or doctors for clarification.

How long will it take to receive semen analysis results?

Individuals or couples who are registered as Illume Fertility patients should receive a call with their results from their nurse or doctor within 5-7 business days.

Outside patients who are referred to us by their physician should expect their results within 7-10 business days. Reports are reviewed by lab staff and then faxed to your referring physician once signed off. 

What if my test results aren't optimal?

Usually two or more semen samples (taken at separate intervals) are analyzed because it’s normal for sperm counts to fluctuate. 

If sperm abnormalities are detected, a semen analysis can be repeated in 4-6 weeks to determine if they are permanent or temporary. If the sperm analysis is normal, your doctor will probably recommend a thorough testing of your female partner before considering additional male infertility tests.

How to Improve Sperm Health

Low sperm count is called oligospermia. Theoretically, it only takes one sperm to fertilize an egg, but the odds of one sperm reaching the egg are very low. Consequently, a low sperm count reduces a man’s chances of fathering a child.

A urologist can suggest medical or surgical treatments to increase those odds.

Note: We recommend all couples trying to conceive avoid smoking, excessive drinking, and drug use, maintain a healthy weight, and stay away from excessive heat (like tubs and saunas) that can temporarily reduce sperm count.

Part 3: More Semen Analysis FAQs

What happens to my sample once you’re done analyzing it?

Once we are done testing a sperm sample, it is immediately discarded into a secure biomedical waste bin. This ensures that your sample does not remain in the lab unless you've consented otherwise (i.e. for sperm cryopreservation storage).

Discarded specimens are disposed of according to strict protocols ensuring that there is no risk being transferred.

How do you prevent sperm sample mix-ups?

Illume Fertility has a very strict and well thought out protocol to specifically avoid any mix-up of specimens. We will have you review and initial 15 labels that we will use for your specimen and paperwork. Your specimen cup will be labeled twice, and it will be sealed by you.

All specimens are logged into a book where we record several identifying factors.

We also assign a unique accession number specifically to your sample while performing any procedure as part of our extensive security protocol. If you have any concerns, please reach out to any Illume team member. We want to ensure your comfort throughout the process.

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Can I produce a sample at home?

Yes. If you prefer to produce a sample at home, please be sure to pick up a collection kit from any of our offices. It will provide everything you need to properly collect your sample.

Note: Please make sure to bring the sample in to your Illume Fertility office within 45 minutes from the time of collection to ensure the most accurate results.

How much does a semen analysis cost?

The cost of a semen analysis depends on your insurance coverage. If your insurance does not cover any part of the analysis, your Insurance & Billing Advocate will discuss out-of-pocket pricing with you.

Understanding Male Fertility

Uncovering your current fertility potential is step one in the entire family-building process. But in order to feel confident and not overwhelmed by all the medical jargon, it’s important to know what’s happening with testing and treatment.

We want you to feel as confident and empowered as possible - whether you are undergoing a semen analysis yourself, have a male partner preparing for this appointment, or are curious about how your sperm donor's sample is evaluated.

This is just a small example of what we do here at the Illume Fertility Andrology Lab. If you have any questions, we encourage you to ask a lab staff member. We're happy to help!

Sierra Dehmler

Sierra Dehmler is Illume Fertility’s Content Marketing Manager - and also a fertility patient herself. Combining empathy gained on her personal journey with her professional experience in marketing and content creation, she aims to empower and support other fertility patients by demystifying the fertility treatment process.

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