Semen Analysis: Key Questions and Concerns Explained - Urology

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Understanding semen analysis is crucial for couples facing challenges with conception. In your case, it’s important to interpret the results of your semen analysis in the context of fertility. Let's break down the components of your report and address your concerns.

1. Volume (8.0 mL): The normal range for semen volume is typically between 1.5 mL and 5 mL per ejaculation. Your volume of 8.0 mL is considered above the normal range, which could indicate hypersecretion or possibly a longer abstinence period before the test. While a higher volume is not inherently problematic, it may be worth discussing with your healthcare provider to understand the implications.

2. Color (Milk-like): A milk-like appearance is generally normal for semen. It indicates the presence of seminal fluid, which is essential for sperm motility and viability.

3. pH (8.0): The normal pH range for semen is between 7.2 and 8.0. Your pH of 8.0 is at the upper limit of normal. A higher pH can sometimes indicate an infection or other issues, but in your case, it is still within acceptable limits.

4. Viscosity: The viscosity levels you provided (Middlea級 41, b級 20, c級 4, d級 35) suggest varying degrees of thickness. Normal semen should be somewhat viscous, but excessive viscosity can hinder sperm motility. If your viscosity is significantly higher than normal, it could be a factor affecting fertility.

5. Sperm Count (582 million): The normal sperm count is typically above 15 million sperm per mL, with a total count of over 39 million per ejaculation considered normal. Your count of 582 million is significantly above the normal range, which is a positive indicator for fertility.

6. RBC (1-3): The presence of red blood cells in semen is not typical. While a small number may not be alarming, it can indicate potential issues such as inflammation or infection. It would be advisable to follow up on this finding with your doctor.

7. WBC (5-4): White blood cells in semen can indicate an infection or inflammation. A count of 5-4 suggests a slight increase, which may warrant further investigation to rule out any underlying infections.

8. Normal (75%) and Abnormal (25%) Sperm: A normal morphology percentage of 75% is considered good, as normal sperm morphology is typically above 4% according to WHO standards. The 25% abnormal sperm may not be a significant concern, especially if the majority are normal.

9. Sperm Motility: You mentioned that the motility is classified as a級+b級, which indicates that a significant percentage of sperm are motile. This is a positive sign, as motility is crucial for successful fertilization.

In summary, while your sperm count is excellent, the presence of red and white blood cells, along with the viscosity and volume, may require further investigation. It is essential to discuss these results with your healthcare provider, who may recommend additional tests or evaluations to ensure there are no underlying issues affecting your fertility. Additionally, factors such as lifestyle, diet, and overall health can also play significant roles in fertility, so consider discussing these aspects with your doctor as well.