Semen Analysis Results: Variations and Implications

Q: Semen Analysis Results: Variations and Implications

Hello, the body's tissues are constantly changing. <br>For example, blood pressure measurements can vary every hour. <br>As for semen, there are even more factors involved. <br>After all, sperm development takes about two and a half months, and any abnormalities in health or nutr

Semen analysis report results?

Doctor, about seven months ago, I had a semen analysis done at a laboratory with the following results.
I abstained for 5 days and collected the sample through masturbation into a paper cup.
The results were as follows:
- Appearance: Grayish-white
- Total volume: 4.5 cc (Reference range: 1.5-7.0 cc)
- Liquefaction time: 25 minutes (Reference range: 30 minutes)
- pH: 8.5 (Reference range: 7.2-8.9)
- Motility after 1 hour: 85% (Reference value: >75%)
- Motility after 2 hours: 70% (Reference value: >60%)
- Normal sperm morphology: 87% (Reference value: >80%)
- Red blood cells: 0-1 (Reference range: 0-1)
- White blood cells: 1-2 (Reference range: 1-2)
- Epithelial cells: 2-3 (Reference range: 3-5)
- Sperm count: 31,000/cc (Reference value: >3,000/cc)
Since my partner has not become pregnant, I went to another laboratory this month for another test.
I abstained for 7 days and collected the sample through masturbation into a condom.
The results were as follows:
- Appearance: Grayish-white
- pH: 7.5 (Reference range: 5.0-8.0)
- Total volume: 2.2 cc (Reference range: 1.5-7.0 cc)
- Sperm count: 5,120/cc (Reference value: >5,000/cc)
- Rapid motility: 65% (Reference value: >60%)
- Slow motility: 14% (Reference value: <15%)
- Non-motile: 21% (Reference value: <40%)
- Normal sperm morphology: 64% (Reference value: >50%)
- Red blood cells: 1-2 (Reference range: 0-2)
- White blood cells: 2-3 (Reference range: 0-2)
- Epithelial cells: 0-1
- Liquefaction time: 70 minutes (Reference value: <120 minutes)
I would like to ask the doctor why the reference values from the laboratories are different.
Why is there such a significant difference in sperm count and normal sperm morphology between the two reports? Is it due to the number of days of abstinence? Why did the doctor in the second test advise me to collect the sample in a condom? Is that accurate? The key point is that although both results are normal, the reference values differ.
Should I get tested again?

aki, 20~29 year old female. Ask Date: 2011/06/02

Dr. Xu Weikai reply Urology

Hello, the body's tissues are constantly changing.
For example, blood pressure measurements can vary every hour.
As for semen, there are even more factors involved.
After all, sperm development takes about two and a half months, and any abnormalities in health or nutrition during this time can affect sperm quality or quantity.
Additionally, ejaculation within a condom can sometimes be influenced by the presence of spermicides or lubricants, which may affect test results.
However, your second test results are within the normal range for that testing center.
Infertility is a shared issue between both partners.
Sometimes, it is important to consider whether there is a compatibility issue with bodily fluids, such as the presence of antisperm antibodies in the female partner, which requires further analysis.
Furthermore, stress can also contribute to difficulties in conception.
Of course, the current concern regarding plasticizers, when consumed in excess, may interfere with fertility, which could indirectly explain part of the reason for Taiwan's low birth rate.

Recommendations: Maintain a regular schedule, eat a balanced diet, and avoid excessive intake of processed foods; opt for natural foods and avoid artificial additives.
Taking a long vacation, ideally more than 14 days, in alignment with the ovulation cycle can also be beneficial, as many couples have conceived this way.
It is advisable to check for any compatibility issues with bodily fluids.
If you have any further questions or need clarification, feel free to ask for further discussion and research.

Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2011/06/02

More Info

Understanding semen analysis results can be quite complex, especially when you have variations between different tests. Let's break down the key components of your semen analysis reports and address your concerns regarding the differences in reference values, sperm count, and morphology.

Overview of Semen Analysis
Semen analysis is a crucial test for evaluating male fertility. It assesses various parameters, including sperm count, motility (movement), morphology (shape), and the overall characteristics of the semen. The World Health Organization (WHO) provides reference values for these parameters, which can vary slightly between laboratories due to differences in equipment, techniques, and population samples.

Your Test Results
1. First Test Results (7 months ago):
- Total Volume: 4.5 cc (Normal range: 1.5-7.0 cc)
- Liquefaction Time: 25 minutes (Normal: <30 minutes)
- pH: 8.5 (Normal: 7.2-8.9)
- Sperm Motility:
- 1st hour: 85% (Normal: >75%)
- 2nd hour: 70% (Normal: >60%)
- Normal Sperm Morphology: 87% (Normal: >80%)
- Sperm Count: 31,000/cc (Normal: >3,000/cc)
2. Second Test Results (recent):
- Total Volume: 2.2 cc (Normal range: 1.5-7.0 cc)
- pH: 7.5 (Normal: 5.0-8.0)
- Sperm Count: 5,120/cc (Normal: >5,000/cc)
- Motility:
- Rapid: 65% (Normal: >60%)
- Slow: 14% (Normal: <15%)
- Non-motile: 21% (Normal: <40%)
- Normal Sperm Morphology: 64% (Normal: >50%)

Addressing Your Concerns
1. Variations in Reference Values:
- Different laboratories may use slightly different reference ranges based on their population studies and methodologies. It’s essential to compare your results against the specific reference ranges provided by each lab. The WHO guidelines are commonly used, but variations can occur.

2. Differences in Sperm Count and Morphology:
- The sperm count and morphology can fluctuate due to various factors, including the duration of abstinence (or "禁慾"). A longer abstinence period can lead to higher sperm counts, while shorter periods may result in lower counts. In your case, the first sample was taken after 5 days of abstinence, while the second was after 7 days. This difference may have contributed to the variations in sperm count and morphology.

- Additionally, the method of collection (using a paper cup vs. a condom) can also influence the results. Some studies suggest that using a condom can lead to lower sperm counts due to potential loss of sperm during transfer or the presence of substances in the condom that may affect sperm viability.

3. Should You Retest?:
- Since both tests show normal results, it may not be necessary to retest immediately unless there are ongoing concerns regarding fertility or if advised by your healthcare provider. However, if you and your partner are still experiencing difficulties conceiving, further evaluation may be warranted. This could include additional semen analyses or other fertility assessments.

4. Next Steps:
- It’s advisable to discuss these results with a urologist or a fertility specialist who can provide personalized insights based on your medical history and current situation. They may recommend lifestyle changes, further testing, or treatments if necessary.

Conclusion
In summary, while your semen analysis results are largely within normal ranges, variations can occur due to multiple factors, including the method of collection and the duration of abstinence. If you have concerns about fertility, it’s best to consult with a specialist who can guide you through the next steps based on your specific circumstances.

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