Sperm Analysis - Insights, Methods, and Clinical Implications

What Is Sperm Analysis?

A sperm or semen analysis is also known as the sperm count test. This test aims to analyze the health and viability of a male's sperm. Semen is a fluid that contains sperm and other substances. It is released during ejaculation into the female genital tract. Some doctors conduct two or three separate sperm analyses to get an idea about sperm and semen quality. As per the study reports, the test must be conducted seven days and over two to three months. This is because variations in sperm count can be noticed daily. Therefore, obtaining an average of the semen analysis helps to measure the following major aspects of a male sperm:

• The number of sperms.

• The shape of sperm.

• Sperm motility or the movement of sperm.

Why Should a Patient Undergo a Semen Analysis Test?

The patient might need to undergo a semen analysis test for the following reasons:

1. Male Infertility - A semen analysis is usually recommended when couples find it difficult to get pregnant. This test will help determine whether the male is fertile or infertile. It also helps the patient know whether low sperm count or sperm dysfunction is the reason behind male infertility.

2. Vasectomy - Vasectomy is a surgical procedure in which the vas deferens tubes are cut or ligated to prevent a male from becoming a father. People who have undergone vasectomy undergo semen analysis tests to check whether there are no sperms in their semen. After vasectomy, some doctors might recommend the patient undergo a semen analysis test once every three months to ensure that no sperms are present in their semen.

What Is the Normal Sperm Count and Volume?

Sperm count and volume are important if the patient plans to conceive a child because an abnormal sperm volume or sperm count might be indicative of an underlying medical condition. The average sperm volume ranges from 2 to 5 ml (milliliter), whereas the average sperm count ranges from 15 million to more than 200 million sperm per ml of semen. Anything less or more than the above values is considered an abnormal sperm count or volume. The sperm analysis can be done at home or in the doctor's clinic.

What Does a High-Sperm Volume Indicate?

Hyperspermia, or high sperm volume, is when a man produces more semen. It leaves the body through the penis when the person ejaculates during an orgasm. Hyperspermia is a rare condition that does not cause physical changes or affect the patient's health. However, patients suffering from this condition might experience reduced fertility. According to the doctors, a patient can be considered to have hyperspermia only when the semen volume is more than 5.5 or 6 ml per ejaculation. Sometimes, hyperspermia is not due to the sperm but might be due to the body producing more other fluids that make up the semen. For example, the liquids released by the prostate gland and seminal vesicles are also responsible for increased semen volume.

What Are the Causes of Hyperspermia?

The exact causes of prolonged hyperspermia are still unknown. The study reports that a patient might experience temporary hyperspermia, but the sperm volume returns to normal after some time. Some experts believe there is a link between hyperspermia and dietary and lifestyle modifications. For example, people taking herbs, medications, or supplements to stimulate the sexual organs are more likely to experience hyperspermia. However, there is no scientific evidence behind this theory. Other theories suggest that a long-standing prostate gland infection causes inflammation in the area, producing excess semen.

What Are the Signs and Symptoms of Hyperspermia?

The primary symptom of hyperspermia is producing a large amount of semen. People suffering from hyperspermia throughout their lives might fail to notice that their semen volume is large. The only trouble that men suffering from hyperspermia encounter is that they find difficulty in getting their partners pregnant. If their partners become pregnant, there is a high chance that they will suffer from miscarriage. It has been noticed that males suffering from hyperspermia have a higher sex drive than the ones who do not have this condition.

How Does Hyperspermia Affect Male Fertility?

Normally, hyperspermia does not significantly affect male fertility, but sometimes, a male might have low fertility due to hyperspermia. People with a high semen volume might have fewer sperms than normal in their ejaculate because the other fluids in the semen dilute the levels. This dilution procedure negatively affects male fertility. Low sperm count might make a person infertile, but the ones suffering from hyperspermia can conceive but possess low fertility levels, and they must consult their doctor for further evaluation.

How Is Hyperspermia Managed?

Sometimes, people suffering from hyperspermia do not require any treatment. However, if hyperspermia is accompanied by low fertility, it might affect male fertility. Therefore, doctors might recommend the following treatments for people suffering from hyperspermia and trying to conceive:

A. Medications - Certain estrogen receptor blockers might help improve sperm count. Clomiphene citrate is one such medication that stimulates the production of hormones in the brain. However, this drug is less used because it is off-label.

B. Assisted Reproductive Therapy - This refers to doctors' treatment procedures to increase the chances of successful conception. These procedures mainly comprise in vitro fertilization and intracytoplasmic sperm injection. Reproductive therapy mainly includes mixing the sperm and the egg outside the body and implanting the fertilized egg back into the uterus or womb. Hence, this procedure increases the chances of a safe pregnancy.

What Does a Low-Sperm Volume Indicate?

Hypospermia is when the male produces an abnormally low volume of semen. The seminal volume is less than 1.5 ml per ejaculation. As per the WHO (World Health Organization), a male who is sexually stimulated and is not exhausted from sexual activities must produce 1.5 to 6 ml of semen. It has been noted that one percent of the volume of the seminal fluid is sperm cells. Hypospermia must not be confused with oligospermia as the latter is a condition in which the semen has a low sperm count. However, people suffering from hypospermia and oligospermia simultaneously are more likely to remain infertile.

What Are the Causes of Hypospermia?

Hypospermia mainly occurs due to problems in the prostate gland or seminal vesicles. The causes of hypospermia are listed below:

1. Semen Analysis - The most common cause of hypospermia is the ejaculation collection error when the patient provides the semen sample for sperm analysis. There would be abnormalities in the semen analysis report if the first or the last part of the ejaculate were lost during collection.

2. Retrograde Ejaculation - People suffering from congenital defects or taking medications to treat benign prostate hyperplasia are more likely to suffer from hypospermia. This is because when these people ejaculate, the sperm return to the bladder instead of outside the body.

3. Problems of the Seminal Vesicles and Vas Deferens - Congenital absences of vas deferens and seminal vesicles are one of the causes of hypospermia.

4. Ejaculatory Duct Problems - People suffering from problems of the ejaculatory duct, including inflammation and infection of the duct, are more likely to suffer from hypospermia.

What Are the Risk Factors for Hypospermia?

The risk factors for hypospermia are listed below:

• Alcohol and drug abuse.

• Infections.

• Unhealthy lifestyle.

• Old age.

• Hormonal imbalance.

• Stress.

• Psychological problems.

• Testicular trauma.

• Backward flow of semen.

• Obstruction of the ejaculatory duct.

How Is Hypospermia Managed?

There is no specific treatment plan to increase the quantity of semen. However, some pharmacotherapeutic measures have been suggested to increase ejaculation. These measures include taking antibiotics and herbal or pharmaceutical supplements to increase secretion. Surgical therapy is usually done in cases of retrograde ejaculation. In addition, certain surgeries help treat the condition due to congenital malformation. If all the treatments fail to produce the desired results, assisted reproductive techniques are the final solution. If hypospermia is accompanied by oligospermia (reduced sperm count) or poor sperm motility, artificial insemination or in vitro fertilization can be done.

Conclusion:

Sperms are motile reproductive cells of the male body that fuse with the eggs in the female body to form the future baby or the embryo. A semen or sperm analysis test helps measure sperm motility, semen volume, and other factors. Amongst all these parameters, sperm volume is important because it determines a male's fertility. However, several factors might affect the semen analysis results. So, the patient must not worry and consult the doctor at the earliest to know about the sperm volume and semen analysis for better outcomes.