Sunday, 15 April 2012

Part II: How to Read your Sperm Analysis. The Good, The Bad & The Ugly

The truth is out about Men's infertility. Now we are faced with the cold hard facts. The results of your Semen Analysis stare you straight in the face. What information does this piece of paper hold. Is it good or is it just plain bad? 

A Semen Analysis considers many factors. However, it is the Morphology that is the most important aspect of the analysis. Good sperm is what will fertilize the egg.

The World Health Organization provides a definition of a 'normal' sperm count:
      -  Volume: >1.5ml
- Concentration: >15 million/ml
- Motility: >40% forward rapid progressive
- Morphology: >4% normal forms

To qualify for "good sperm" your values need to be greater than the above reference values.

Volume: You need to be able to provide a good volume of semen. The average volume of semen produced at ejaculation is between 2 and 6 ml. A low or absent volume can suggest the possibility of failed emission, incomplete collection, a short abstinence interval or structural obstructions.

Concentration: The concentration of spermatozoa should be at least 20 million per ml. Azoospermia describes the ABSENCE of sperm on a standard microscopic examination. We need to see visible swimmers! Oligospermia (Oligo = few) is defined traditionally by a sperm density less than 20 million/ML and is considered severe when the sperm concentration is below 5 million/ML. And what is considered a normal sperm specimen contains more than 15million/ML.

Motility: Quality sperm is better than the count. Sperm motility is the percantage of sperm moving. Sperm that can move forward fast are  the sperm capable of swimming up to the egg and fertilizing it. Forward progression is graded on an arbitrary scale (Grade 0-4) and most often reported as the percentages exhibiting rapid (grade 3-4), slow (grade 2) and non-progressive motility (grade 0-1). You can see below:
  • Grade 4 sperm are those that swim forward fast in a straight line.
  • Grade 3 sperm swim forward, but either in a curved or crooked line, or slowly.
  • Grade 2 sperm move their tails, but do not move forward.
  • Grade 0-1 sperm do not move at all. Sperm of grade 2 and 1 are considered poor.

So far, your results are looking pretty good. Your volume, motility and concentration are all within reasonable parameters. Now for the big one- morphology. This is when you will hear the Doctor say your results are good or you need to do ICSI/IVF. "The Good, The Bad and The Ugly".  When they talk about ICSI you know it’s serious. This indicates your sperm analysis has come back with low sperm morphology percentages. For males and their partners, this can come as a complete shock.

Sperm morphology: reflects the quality of spermatogenesis- the process of becoming spermatozoa (sperm). If your sperm analysis reads 92% morphology. This indicates only 8% of your sperm are morphologically sound- which is not great. Sperm classified as normal must be NORMAL in all respects. Generally speaking for men, conventional fertilization rates are highest when you have a percentage of sperm that is 14% or higher. Any percentages that fall close to 6-4 % doctors will normally indicate that you look at your options of doing ICSI. 

What distinguishes morphologically sound sperm?
Ideally,  good sperm should have a regular oval head, with a connecting mid-piece and a long straight tail. Morphological abnormalities are categorized by location involving the head, neck (midpiece) or tail. Abnormal sperm is distorted in its shape. If too many sperm are abnormally shaped (round heads; pin heads; very large heads; double heads; absent tails) this may mean the sperm are abnormal and will not be able to fertilize the egg.
When you are diagnosed with low sperm morphology it is extremely important you take a long hard look at lifestyle and also medical history. Sometimes, poor Semen Analysis can be due to trauma or structural abnormalities. 

According to Chinese medicine your reproductive health is the result of your body being in proper balance. Stress, poor lifestyle, inadequate diet and other factors can disturb your natural balance. This results in poor health including impaired semen quality and quantity. 

What Can you do to improve your sperm quality and morphology.
  • Take COQ10
  • Brazil Nuts are high in selenium
  • Take a Zinc Supplement or  eat pumpkin seeds they are great source of Zinc
  • Take Vitamin E
  • Stop Alcohol
  • Supplement with Vital Greens, they are high in anti-oxidants.
  • Include lots of green vegetables in your diet.
  • Stop drinking coffee and substitute for tea
  • Take Create the Essence - chinese herbal supplement.

Generally if you modify your lifestyle you can change the quality of your sperm. Remember it does take 70 days for sperm to develop. The good news is, new sperm is constantly being produced. At Angea we offer specific treatments in treating poor semen Analysis results.  You can contact the clinic to discuss.



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