The Institute for Women's Health

With June designated as Male Health Month, it may be a good time to consider that a couple’s infertility problems are due to male infertility in about 30 % of the time.

ThinkstockPhotos-176844784We all know that it takes one egg and one sperm to achieve a successful pregnancy. The average human ejaculation contains over 90 million sperm but if this number drops to below 20 million sperm per milliliter then infertility difficulties may occur. A semen analysis (SA) is one of the first study ordered in every infertility consultation. A normal SA includes: a volume of 2 to 5 milliliters (mls), at least 20 million sperm per ml, more than 50 % active motile sperm, over 15% normal mature shaped sperm, good active progressively moving sperm, and the semen ejaculate should gel then liquefy in 30 minutes. All these numbers can be taken as a whole evaluation and we end up with a calculated figure: Total Motile (volume x concentration x motility %) should be at least 20 million active, progressively motile sperm. This Total Motile number is the effective number of sperm delivered to the woman’s reproductive system.

ThinkstockPhotos-99911833Various factors can effect normal sperm production. Certain medications can alter the SA results: cimetidine ( Tagamet), testosterone ( injections, patches, or ointment), nitrofurantoin, sulfasalazine, and certain chemotherapy agents. Social habit agents like alcohol, androgen-like or muscle-building additives, caffeine, cocaine, large doses of echinacea, marijuana, St John’s wort, and tobacco alter sperm analysis results. Exposure to prolonged heat, certain pesticides, some spermicides, and radiation can also affect sperm production. Various anatomic problems such as: a varicocele (an enlarged varicose vein in the scrotum), retrograde ejaculation (where the sperm travels up into the man’s bladder), absence of vas deferens (the tube that carries the sperm out from the testes), and an unsuccessful repair of a vasectomy can all lead to abnormal sperm concentration.

Excessive intake of soy, soy burgers, and edamame was linked to lower sperm counts in a 2008 medical research report. Overweight and obese men also tend to have lower SA results. Also, some worldwide studies suggest a drop in sperm concentrations over the last 50 years but these reports have limited scope and need more rigid analysis. Advancing civilization’s varied environmental changes may being compounding the problem but no single factor or factors have be incriminated as of yet.

It is important to get a semen analysis done early in the first stages of fertility treatment. This test painless, non-invasive, and relatively inexpensive. If your doctor has not ordered this simple test, ask about getting one done.

Dr. Joseph R. Garza
The Institute for Women’s Health