Semen Analysis: Common Concerns and Questions

Semen Analysis Report and Questions

Hello, Doctor:
1.
After our last consultation, the analysis report has come out.
The urologist mentioned that it is rare; I have over 187 million of that substance.
At that time, I wasn't sure if I ejaculated twice, which might explain the high count! I only know that after masturbation, there was only one ejaculation, and it was into a tube.

2.
I have doubts about the accuracy of the analysis report! If I have that many, then why have all my past girlfriends been infertile?
3.
I have had girlfriends who had trichomoniasis or sexually transmitted infections, and I did not use a condom at that time.
I was infected with trichomoniasis, but I sought medical attention, and there were no signs of STIs on my genitalia! So I really don't understand why I am infertile! I think only by being in a committed relationship with one woman and planning to have children would I know the real reason!
4.
However, I have a mental illness—depression—and I am very afraid of passing it on to my child.
If it is hereditary, then it might be better not to have children!
5.
Now, every time I urinate after masturbation, there are a lot of bubbles.
Should I consult a urologist or a nephrologist? I apologize for asking you so many questions!

Jason, 30~39 year old female. Ask Date: 2016/01/07

Dr. Fu Shizhang reply Urology

1.
Even a single ejaculation containing 180 million sperm is not considered abnormal.

2.
Infertility is a matter of probability.

3.
If the semen analysis is normal, the cause of infertility is not due to the male partner.

4.
Research on the genetic correlation of mental disorders is outside the scope of urology and cannot be addressed.

5.
Urinalysis can be performed in both specialties.

Reply Date: 2016/01/07

More Info

Understanding semen analysis can indeed be a complex and multifaceted topic, especially when considering the various factors that can influence fertility. Based on your concerns, let’s break down the key points regarding semen analysis, fertility, and the potential implications of your medical history.

Semen Analysis Overview
A semen analysis is a laboratory test that evaluates several parameters of a man's semen and sperm. This includes sperm count, motility (movement), morphology (shape), and overall semen volume. The results can help identify potential fertility issues. In your case, a sperm count of 187 million per milliliter is considered well above the normal range, which typically is above 15 million per milliliter. This suggests that sperm count alone is not likely the issue regarding fertility.

Concerns About Fertility
1. Semen Analysis Accuracy: It’s understandable to question the accuracy of the semen analysis. Factors such as the time of abstinence before the test, the method of collection, and even the laboratory's techniques can influence results. If you have concerns, it may be beneficial to repeat the analysis at a different laboratory or under different conditions.

2. Fertility Despite High Sperm Count: Even with a high sperm count, other factors could contribute to infertility. These include sperm motility (how well the sperm swim), morphology (the shape of the sperm), and the presence of any antibodies that might affect sperm function. Additionally, female partner factors, such as ovulation issues or structural problems, could also play a significant role in fertility.

3. History of STIs: Your history of sexually transmitted infections (STIs) could potentially impact fertility, depending on the type and severity of the infection. For example, infections like chlamydia or gonorrhea can lead to complications such as epididymitis or orchitis, which may affect sperm production or transport. It’s crucial to ensure that any past infections have been adequately treated and that there are no lingering effects.

Psychological Factors
Your concern about having a mental health condition, such as depression, and its potential hereditary implications is valid. Mental health can influence various aspects of life, including relationships and parenting. However, it’s essential to recognize that many individuals with mental health conditions lead fulfilling lives and have healthy families. If you are considering parenthood, discussing your concerns with a mental health professional can provide clarity and support.

Urinary Symptoms
The presence of foamy urine after masturbation could be indicative of several factors, including dehydration, proteinuria (excess protein in urine), or even just the nature of the semen mixing with urine. If this is a persistent issue, it would be wise to consult with a urologist or nephrologist to rule out any underlying kidney or urinary tract issues.

Next Steps
1. Consult a Specialist: Given your concerns about fertility and the potential impact of your medical history, it would be beneficial to consult a reproductive endocrinologist or a urologist specializing in male fertility. They can provide a comprehensive evaluation and recommend further testing if necessary.

2. Mental Health Support: If you have concerns about your mental health and its impact on your life and potential parenting, consider seeking support from a mental health professional. They can help you navigate these feelings and provide strategies for coping.

3. Partner Involvement: If you are in a committed relationship and considering starting a family, involving your partner in discussions about fertility and health can be beneficial. Both partners should ideally undergo evaluations to identify any potential issues.

In conclusion, while your semen analysis shows a high sperm count, fertility is influenced by various factors. Addressing your concerns with healthcare professionals can provide clarity and direction for your next steps.

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