Evaluation of specimen volume, sperm concentration, total sperm count, motility and morphology. The test is usually done by having the partner collect a masturbated sample after abstaining from intercourse for 3-7 days. The sample is ejaculated into a sterile container, usually a sterile wide mouth urine cup, either at home or in the office.

Cancer and Male Infertility may be linked as radiation and chemotherapy treatment for cancer can impair sperm production, sometimes severely. In general, the higher the dose and the longer the treatment, the greater the chance for reproductive problems. Your age, the type and dose of drugs, the location and dose of radiation, the scope and location of surgery, your pre-cancer fertility status, and other factors can influence your risk.

A varicocele is mass of enlarged and dilated veins in the testicle that essentially feels like a bag of worms. It is generally not harmful and usually not painful. A varicocele can be found in 42% of infertile men. About 15% of normal, fertile men also have a varicocele, a fact which complicates the relationship between infertility and varicoceles. Approximately 15 percent of males have this condition which almost always occurs on the left side.

Azoospermia is a condition in which a semen analysis shows an absence of sperm in a man’s semen, although azoospermia is sometimes diagnosed even if as many as 500,000 sperm are found.

All told, this may be a testicular problem, where the testes simply aren’t producing any. It’s also possible that the testes are producing sperm, but they aren’t being delivered. In this case, the problem is in either the ductal system carrying the sperm, or in the process known as emission, in which sperm moves to the urethra prior to ejaculation.

Defined as having a sperm count of under 20 million spermatozoa per milliliter, in short what this means is that there is an insufficient amount of sperm in the semen to make fertility likely. However, oligospermia does not automatically indicate Male Infertility. 

The following are the usual parameters for a normal semen analysis:

Count

More than 20 million sperm/ml

Greater than or equal to 40 x 106 spermatozoa/ejaculate

Concentration

Greater than or equal to 15 x 106 spermatozoa

Motility

More than 40% motile

Morphology

Greater than or equal 4% normal morphology

Semen Volume

1.5 ml or greater

White Blood Cells

Less than or equal to 5 x 106 round cells/ml

Less than 1 million/ml (a high white blood cell count in a sperm sample usually indicates infection, and is often treatable.)

Morphology refers to the shape of the sperm. 70% normally-shaped sperm indicates good morphology. Abnormally shaped sperm appear with malformed heads (two heads, tiny heads, round heads) and tails (two tails, short tails). These shapes tend to affect their motility.

Sperm motility refers to the ability of sperm to move forward by swimming inside the vagina, through the cervix, and into the fallopian tubes, where it could fertilize an egg.

As M. Sara Rosenthal discusses in the “Fertility Sourcebook,” there is debate among the medical community about what constitutes a “healthy” number of sperm. “The World Health Organization (WHO) considers 20 million sperm per milliliter to be fertile; the International Society of Andrology (ISA) consider 40 million sperm per milliliter to be fertile. Generally, anything below 20 million is considered a low sperm count. Anything between 20 and 100 million sperm is considered normal. Keep in mind, however, that sperm numbers can change daily, weekly, and monthly. Colds, flus, STDs, infections, antibiotics, temperature, and ejaculation frequencies all will affect the number. Also keep in mind that men with sperm counts of well below 20 million have often been able to father children.”