Note: Due to the Covid-19 pandemic, in an effort to maximize social distancing in our waiting rooms, there may be the option of producing a semen sample at home and bringing it to the lab. Please speak to a member of our team when booking your semen sample to see if you may be eligible to produce it at home.
General Information
A semen analysis is the primary laboratory test for assessment of male fertility. A period of 2-3 days of ejaculatory abstinence (either through sexual intercourse or masturbation) is required before producing a sample for analysis. If ejaculation has occurred more recently the sperm concentration may be artificially low. In contrast, if the abstinence period is greater than 5 days the quality of the sample may be affected. The sample that you produce in the special private collection rooms at the DSL is immediately placed in an incubator.
At the Calgary Regional Fertility Program, the Diagnostic Semen Laboratory performs a semen analysis using the 2010 World Health Organization (WHO) guidelines. From the WHO standards a series of “normal” parameters have been determined as below.
The semen analysis includes assessment of the following:
Ejaculated Volume – greater than or equal to 1.5 milliliters
Sperm Concentration – greater than or equal to 15 Million sperm/milliliter
Sperm Motility – the number and quality of the sperm movement graded as rapid progressive (RP), slow progressive (SP), non-progressive (NP) and immotile (IM). Normal motility is when Progressive Motility (rapid + slow progressive movement) is at least 32% and Total Mobility (Progressive Motility + Non-Progressive) is 40% or greater.
Sperm Vitality – determines the number of living sperm in a sample. At least 58% of the ejaculated sperm should be alive.
Sperm Morphology – an assessment of the “appearance” of individual sperm. The physical appearance of sperm is assessed with respect to the head and tail characteristics using the Kruger Strict Criteria method. A morphology of 4% or greater is considered normal.
Leucocyte (white blood cell) count – the number of white blood cells in a specimen. High numbers of white blood cells may indicate infection.
Microbiological testing – the semen may be cultured to identify infections of the semen.
Immunologic Testing (Antisperm Antibody Test)
Assessment for the presence of antisperm antibodies that may impair the movement and/or fertilizing ability of the sperm. Under normal circumstances sperm develops in the testes and are completely isolated from the circulatory system (via a blood/testes barrier). If there is a break in this barrier for any reason surface antigens on the sperm can cause the immune system to develop antibodies against the sperm. Antibodies are common following vasectomy or vasectomy reversal and may impair fertility.
Sperm Evaluation for IUI
Not all semen samples are suitable for IUI treatments. Samples with reduced sperm concentration, decreased motility or the presence of antisperm antibodies may not yield adequate numbers for the “sperm wash”. An IUI evaluation may be advised prior to starting treatment to determine the suitability of a man’s sample for IUI.
Sperm Wash/Intrauterine Insemination
Intrauterine insemination (IUI) involves the placement of “washed” sperm (partner or donor sperm) into the uterine cavity prior to ovulation. The chance of conception is increased by placing a large number of motile sperm high in the uterus. The sample for IUI is collected by masturbation at the DSL the morning of the insemination procedure. Approximately 2 hours are needed to perform the “sperm wash” procedure. Sperm washing is also required for Clomiphene Citrate / IUI and Superovulation / IUI cycles.
Preparation of Sperm Samples from PESA, MESA, TESE, Vibrostimulation, and Electroejaculation/Cryopreservation
This option is available for patients wishing to store sperm for future use include those men having radiation, chemotherapy or other treatments that may render them infertile. Sperm samples obtained through masturbation, PESA, MESA, TESE, as well as vibrostimulation and electroejaculation can be processed and cryopreserved (frozen) and stored indefinitely for future use. Service members serving in war zones may wish to store sperm samples prior to their deployment for future use. Cryopreservation and storage of sperm is not paid for by the provincial health care plans and patients using this service will incur initial and annual charges.
Cryopreservation
Samples are assessed for motility and concentration prior to freezing. The sample is mixed with a biocompatible cryoprotectant and frozen in small straws. The straws are frozen in liquid nitrogen. A portion of the frozen sample may be thawed and examined to assess the post-freeze viability and mobility of the sample.
Due to the nature of the sperm freezing it is usual for motility and concentration to be less after freezing and thawing than in the original fresh sample. Therefore there can be no guarantee that the frozen sperm will be suitable for future use. Once frozen the sample may be kept indefinitely. The majority of degradation of the sperm quality occurs at the time of the freeze, not during storage.
Male Karyotype Testing
Approximately 10 percent of men with a very low sperm count will be found to have an abnormality of their chromosomes. Since chromosome abnormalities may rarely cause miscarriages or birth defects all men with a very low sperm count will have this test performed prior to proceeding with treatment. Karyotyping is done using a blood sample from the male partner.
Y-Chromosome Microdeletions
Deletions of small amounts of genetic information from the long arm of the Y chromosome may be found in 10 -15 percent of men with no or very low sperm counts. The deletion of these genes from the Y chromosome significantly affects the production of sperm. Microdeletion testing results are used to predict the likelihood of finding sperm in testicular biopsies. If a child is born as a result of an IVF/ICSI cycle from a man with a Y chromosome microdeletion it is very likely his sons will be born with the same abnormality. This assay is performed on a blood sample from the male partner.