Techie Tuesday: Semen analysis a go-go

Welcome to another Techie Tuesday. I am going to provide a few links to some IF techie things. I want to state clearly that I am not a medical professional.  I am a computer geek/IT professional with over 20 years in the computer and biotech industries. A geeky gal who likes to research her condition/situation/whatever. My supreme computer nerdiness has enabled me to dig up some good places on the net.  I read many articles and want to provide links to the ones that have some great info.  Are you like me?  Desperate to research the tests and procedures that have been recommended to you?  I get it.  I’ve been there.  I am still there.  Let’s a go-go.

According to the CDC’s 2005 statistics report, among couples who have ART cycles, male factor counts for 18.3%, multiple factors (female + male) is and additional 18.5%  The report defines male factor: “Any cause of infertility due to low sperm count or problems with sperm function that makes it difficult for a sperm to fertilize an egg under normal conditions.” 
http://www.cdc.gov/art/ART2005/index.htm

So you are having problems getting pregnant.  The RE puts us gals through a lot of embarrassing and uncomfortable tests and procedures.  Well men should get tested too.  I can’t believe sometimes reading about how long some ladies go through infertility work and testing before getting their male counterparts get tested too.  If your OB/GYN or RE hasn’t tested the other half, it’s time to ask why.

The men get their own chance at humiliation with the Semen Analysis and SPA.  I won’t get into any junior high jokes about providing samples in the doctors office.  OK.  Well…maybe one.  MrBeep and I joke about removing all of the standard RE office provided pR0n and replacing it with entirely hard core male-to-male manlove material.  We snicker about the RE docs saying something like “Wow, the SA sample rates are sky-high this month.  More volume than ever!” 

Back to bloggidy work…so the male counterpart gives his sample and then a couple of weeks later you get the results paperwork.  Once you get this Semen Analysis (SA) report and are thinking (as I did) “eh, so?  What does all this mean?” I understood that our test was labeled “abnormal” and that some numbers were below the reference range.  Other numbers were in the normal range, so how bad are things?  How does this affect our chances? 

I don’t really know.  I know they are affected enough that even with my 28-day on-time like-clockwork mad ovulation skillz we can’t get pregnant.  I know that over two years trying on our own we can’t.  I know DocO and the report recommends IVF with ICSI (which worked in IVF #1 very well.  6 eggs mature, all 6 fertilized using ICSI and 4 made it to 3 day transfer).  Below is a sample of how our results chart was laid out.  I have included links to the articles that I feel either explain the test item in better detail or where I have found useful information.

SEMEN ANALYSIS REPORT

Test/Result	Reference Range	IF Optimist Notes
Volume	Normal: 1.5-4.5 ML	if the volume is too low or too high it can indicate fertility problems.  This site gives an excellent definition.
Sperm Concentration	Normal: 20-150 Million/ml	commonly known as sperm count, which is different from total sperm count (see below).  Oligospermia is a term for low sperm count and azoospermia is a term for a complete absence of sperm in the ejaculate.
Total Count	Normal: > 40 Million/ml	A calculation of the number of moving sperm in the entire ejaculate.  Volume (cc) x concentration (million sperm/cc) x motility (% moving)
Motility	Normal: > 50%	What percentage of the sperm are moving normally.  Sperm that don’t move normally cannot swim up the female reproductive system to find the egg.
Progression	Normal: 3 - 4	This describes how well the sperm that are moving are making progress. Only when the motility (% moving) is combined with the forward progression is an accurate picture of sperm movement obtained.
Viability	Normal: 60 – 95%	Sperm may be alive, but not moving. A specialized staining technique is used to determine what percentage of the sperm are alive.
Sperm Agglutination		Sperm agglutination (sperm sticking together) can be caused by various inflammatory conditions, and are most commonly seen with the presence of antisperm antibodies
Viscosity	The desired viscosity is +1 on a scale of +1 to +4, with liquefaction complete within 10 - 30 minutes.	Viscosity is the rate at which semen liquefies. Semen is initially thick and viscous; the thicker the semen, the more difficult it is for sperm to travel.
Round Cells	Normal: < 3 Million/ml	A large number of round cells may indicate an infection
WBC	Normal: 1 Million/ml	All semen samples have white blood count (WBC) in them. If greater than 1 million WBC per 1 ml are present, there is concern of infection.
Morphology	Normal: > 10% Suboptimal: 5-9% Abnormal: < 4%	Normal sperm have an oval head with a long tail. Abnormal sperm may have head or tail defects — such as a large or misshapen head or a crooked or double tail. These defects may impair the ability of the sperm to reach and fertilize an egg.
Acrosome Reaction (test using Sperm Penetration Assay)	Normal: > 9% Abnormal: < 7%	Levels below normal indicate problems of sperm fertilizing egg.  ICSI is recommended if this is the case.

Here are a few more articles I found on the internet that may help you better understand the test and the data breakdown.

Babyhopes.com: What does Semen Analysis Entail?

WebMD:  Infertility and Reproduction Guide – Semen Analysis – on page 2 this article gives a very detailed breakdown on what abnormal may indicate.

Wikipedia – Semen Analysis:  a pretty good article with lots of links to other sources.

An excellent and comprehensive page on Semen Analysis with good definitions.

Another really excellent page of information about sperm evaluation and testing.

An interesting article on a British website on semen and sperm quality.

Video that describes a little about IVF and shows an egg being fertilized using ICSI.

I know that there are a lot of other bloggers out there who have done some excellent research on male factor.  I would really appreciate it if you were to comment with any articles, websites or any previous blog entry (including your own) that you feel particularly useful.  It is all so overwhelming.   Techie Tuesdays are all about making it easier for others who need to find information when first dealing with infertility diagnosis and testing.  Thanks.