Skip to main content
SpringerLink
Log in

Interpreting Semen Analysis and Level 2 Sperm Testing

  • Chapter
  • First Online:
The Diagnosis and Treatment of Male Infertility

  • 848 Accesses

Abstract

Semen analysis is the first test requested when fertility potential of a man becomes questionable. The results of the semen analysis are often taken as a surrogate measure of his ability to father a pregnancy. The test provides information on the functional status of the seminiferous tubules, epididymis, seminal vesicles, and the prostate. Thus the results of the test should be interpreted in the light of a full clinical history and physical examination of the patient to determine possible causes for reduced fertility potential and of any suboptimal semen analysis result.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Alvarez C, et al. Biological variation of seminal parameters in healthy subjects. Hum Reprod. 2003;18:2082–8.

    Article  CAS  PubMed  Google Scholar 

  2. Pound N, et al. Duration of sexual arousal predicts semen parameters for masturbatory ejaculates. Physiol Behav. 2002;76:685–9.

    Article  CAS  PubMed  Google Scholar 

  3. Zavos PM, Goodpasture JC. Clinical improvements of specific seminal deficiencies via intercourse with a seminal collection device versus masturbation. Fertil Steril. 1989;51:190–3.

    Article  CAS  PubMed  Google Scholar 

  4. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2010.

    Google Scholar 

  5. Bonde JP, Ernst E, Jensen TK, Hjollund NH, Kolstad H, Henriksen TB, Scheike T, Giwercman A, Olsen J, Skakkebaek NE. Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners. Lancet. 1998;352:1172–7.

    Article  CAS  PubMed  Google Scholar 

  6. Guzick DS, Overstreet JW, Factor-Litvak P, Brazil CK, Nakajima ST, Coutifaris C, Carson SA, Cisneros P, Steinkampf MP, Hill JA, Xu D, Vogel DL. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med. 2001;345:1388–93.

    Article  CAS  PubMed  Google Scholar 

  7. Williams WW, McGugan A, Carpenter HD. The staining and morphology of the human spermatozoon. J Urology. 1934;32:201–12.

    Google Scholar 

  8. WHO. Laboratory manual for the examination of human semen and sperm–cervical mucus interaction. 4th ed. Cambridge: Cambridge University Press; 1999.

    Google Scholar 

  9. Auger J, Eustache F, Ducot B, Blandin T, Daudin M, Diaz I, Matribi SE, Gony B, Keskes L, Kolbezen M, Lamarte A, Lornage J, Nomal N, Pitaval G, Simon O, Virant-Klun I, Spira A, Jouannet P. Intra- and inter-individual variability in human sperm concentration, motility and vitality assessment during a workshop involving ten laboratories. Hum Reprod. 2000;15(11):2360–8.

    Article  CAS  PubMed  Google Scholar 

  10. Dunphy BC, Kay R, Barratt CL, Cooke ID. Quality control during the conventional analysis of semen, an essential exercise. J Androl. 1989;10:378–85.

    Article  CAS  PubMed  Google Scholar 

  11. Yeung CH1, Cooper TG, Nieschlag E. A technique for standardization and quality control of subjective sperm motility assessments in semen analysis. Fertil Steril. 1997;67:1156–8.

    Google Scholar 

  12. Verstegen J, Iguer-Ouada M, Onclin K. Computer-aided sperm analysis: past, present and future. Theriogenology. 2002;57:149–79.

    Article  CAS  PubMed  Google Scholar 

  13. Castilla JA, et al. Infl uence of analytical and biological variation on the clinical interpretation of seminal parameters. Human Reprod. 2006;21:847–51.

    Article  CAS  Google Scholar 

  14. Björndahl L, Kvist U. Sequence of ejaculation affects the spermatozoon as a carrier and its message. Reprod Biomed Online. 2003;7:440–8.

    Article  PubMed  Google Scholar 

  15. Ng KK, et al. Sperm output of older men. Human Reprod. 2004;19:1811–5.

    Article  CAS  Google Scholar 

  16. Andersen AG, et al. High frequency of sub-optimal semen quality in an unselected population of young men. Human Reprod. 2000;15:366–72.

    Article  CAS  Google Scholar 

  17. Holstein AF, et al. Understanding spermatogenesis is a prerequisite for treatment. Reprod Biol Endocrinol. 2003;1:107.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Welliver C, Benson AD, Frederick L, Leader B, Tirado E, Feustel P, Kontio J, McAsey M, Köhler TS. Analysis of semen parameters during 2 weeks of daily ejaculation: a first in humans study. Transl Androl Urol. 2016;5:749–55.

    Google Scholar 

  19. Agarwal A, Gupta S, Du Plessis S, Sharma R, Esteves SC, Cirenza C, Eliwa J, Al-Najjar W, Kumaresan D, Haroun N, Philby S, Sabanegh E. Abstinence time and its impact on basic and advanced semen parameters. Urology. 2016;94:102–10.

    Article  PubMed  Google Scholar 

  20. De Jonge C, LaFromboise M, Bosmans E, Ombelet W, Cox A, Nijs M. Influence of the abstinence period on human sperm quality. Fertil Steril. 2004;82:57–65.

    Article  PubMed  Google Scholar 

  21. Lewis-Jones I, Aziz N, Seshadri S, Douglas A, Howard P. Sperm chromosomal abnormalities are linked to sperm morphologic deformities. Fertil Steril. 2003;79:212–5.

    Article  PubMed  Google Scholar 

  22. Aziz N, Agarwal A, Lewis-Jones I, Sharma RK, Thomas AJ Jr. Novel associations between specific sperm morphological defects and leukocytospermia. Fertil Steril. 2004;82(3):621–7.

    Article  PubMed  Google Scholar 

  23. Aziz N, Agarwal A, Lewis-Jones I, Sharma RK, Thomas AJ Jr. High sperm deformity index (SDI) and acrosomal damage in infertile men with leukocytospermia. Fertil Steril. 2004;82:621–7.

    Article  PubMed  Google Scholar 

  24. Aziz N, Saleh RA, Sharma RK, Lewis-Jones I, Esfandiari N, Thomas AJ Jr, Agarwal A. Novel association between sperm reactive oxygen species production, sperm morphological defects, and the sperm deformity index. Fertil Steril. 2004;81:349–54.

    Article  CAS  PubMed  Google Scholar 

  25. Aziz N, Agarwal A. Evaluation of sperm damage: beyond the World Health Organization criteria. Fertil Steril. 2008;90:484–5.

    Article  PubMed  Google Scholar 

  26. de la Taille A, Rigot JM, Mahe P, Gervais R, Dumur V, Lemaitre L, et al. Correlation of genitourinary abnormalities, spermiogram and CFTR genotype in patients with bilateral agenesis of the vas deferens. Prog Urol. 1998;8(3):370–6.

    PubMed  Google Scholar 

  27. Daudin M, Bieth E, Bujan L, Massat G, Pontonnier F, Mieusset R. Congenital bilateral absence of the vas deferens: clinical characteristics, biological parameters, cystic fibrosis transmembrane conductance regulator gene mutations, and implications for genetic counseling. Fertil Steril. 2000;74(6):1164–74.

    Article  CAS  PubMed  Google Scholar 

  28. Mortimer D. Semen analysis and other standard laboratory tests. In: Hargreave T, editor. Male infertility. 2nd ed. London: Springer; 1994. p. 55–6.

    Google Scholar 

  29. Aust TR, Brookes S, Troup SA, Fraser WD, Lewis-Jones DI. Development and in vitro testing of a new method of urine preparation for retrograde ejaculation; the Liverpool solution. Fertil Steril. 2008;89(4):885–91.

    Article  PubMed  Google Scholar 

  30. Jefferys A, Siassakos D, Wardle P. The management of retrograde ejaculation: a systematic review and update. Fertil Steril. 2012;97(2):306–12.

    Article  PubMed  Google Scholar 

  31. Mehta A, Sigman M. Management of the dry ejaculate: a systematic review of aspermia and retrograde ejaculation. Fertil Steril. 2015;104:1074–81.

    Article  PubMed  Google Scholar 

  32. Meacham R. From androlog. J Androl. 2002;23(3):330–1.

    PubMed  Google Scholar 

  33. Aziz N. The importance of semen analysis in the context of azoospermia. Clinics (Sao Paulo). 2013;68(Suppl 1):35–8.

    Article  Google Scholar 

  34. Samplaski MK, Lo KC, Grober ED, Millar A, Dimitromanolakis A, Jarvi KA. Phenotypic differences in mosaic Klinefelter patients as compared with non-mosaic Klinefelter patients. Fertil Steril. 2014;101(4):950–5.

    Article  PubMed  Google Scholar 

  35. Wikstrom AM, Raivio T, Hadziselimovic F, Wikstrom S, Tuuri T, Dunkel L. Klinefelter syndrome in adolescence: onset of puberty is associated with accelerated germ cell depletion. J Clin Endocrinol Metab. 2004;89(5):2263–70.

    Article  PubMed  Google Scholar 

  36. Davis SM, Rogol AD, Ross JL. Testis development and reproductive options in males with klinefelter syndrome. Endocrinol Metab Clin North Am. 2015;44:843–65.

    Article  PubMed  PubMed Central  Google Scholar 

  37. McBride JA, Coward RM. Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use. Asian J Androl. 2016;18:373–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Rahnema CD, Lipshultz LI, Crosnoe LE, Kovac JR, Kim ED. Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertil Steril. 2014;101:1271–9.

    Article  CAS  PubMed  Google Scholar 

  39. Björndahl Lars. What is normal semen quality? On the use and abuse of reference limits for the interpretation of semen analysis results. Human Fertil. 2011;14:179–86.

    Article  Google Scholar 

  40. Keel B, Webster B. The standard semen analysis. In: Webster B, editor. CRC handbook of the laboratory diagnosis and treatment of infertility. Boca Raton, FL: CRC Press; 1990. p. 27–69.

    Google Scholar 

  41. Nallella KP, Sharma RK, Aziz N, Agarwal A. Significance of sperm characteristics in the evaluation of male infertility. Fertil Steril. 2006;85:629–34.

    Article  PubMed  Google Scholar 

  42. Tomlinson MJ. Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress? Andrology. 2016;4(5):763–70.

    Article  CAS  PubMed  Google Scholar 

  43. Zini A, Kamal K, Phang D, Willis J, Jarvis K. Biologic variability of sperm DNA denaturation in infertile men. Urology. 2001;58:258–61.

    Article  CAS  PubMed  Google Scholar 

  44. Evenson D, Larson K, Jost L. Sperm chromatin structure assay: its clinical use for detecting sperm DNA fragmentation in male infertility and comparisons with other techniques. J Androl. 2002;23:25–43.

    Article  PubMed  Google Scholar 

  45. Evenson D, Larson K, Jost L. Sperm chromatin structure assay: its clinical use for detecting sperm DNA fragmentation in male infertility and comparisons with other techniques. J Androl. 2002;23:25–43.

    Article  PubMed  Google Scholar 

  46. Agarwal A, Prabakaran SA. Mechanism, measurement, and prevention of oxidative stress in male reproductive physiology. Indian J Exp Biol. 2003;43:963–74.

    Google Scholar 

  47. Aziz N, Said T, Paasch U, Agarwal A. The relationship between human sperm apoptosis, morphology and the sperm deformity index. Hum Reprod. 2007;22:1413–9.

    Article  PubMed  Google Scholar 

  48. Aitken RJ, Koopman P, Lewis SE. Seeds of concern. Nature. 2004;432:48–52.

    Article  CAS  PubMed  Google Scholar 

  49. Kobayashi H, Larson K, Sharma RK, Nelson DR, Evenson DP, Toma H, et al. DNA damage in patients with untreated cancer as measured by the sperm chromatin structure assay. Fertil Steril. 2001;75:469–75.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gynecology and Reproductive Medicine, Liverpool Women’s Hospital and The University of Liverpool, Liverpool, UK

    Nabil Aziz

Authors
  1. Nabil Aziz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nabil Aziz .

Editor information

Editors and Affiliations

  1. Liverpool Women's Hospital, Liverpool, United Kingdom

    Nabil Aziz

  2. Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio, USA

    Ashok Agarwal

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Aziz, N. (2017). Interpreting Semen Analysis and Level 2 Sperm Testing. In: Aziz, N., Agarwal, A. (eds) The Diagnosis and Treatment of Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-319-56547-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56547-7_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56545-3

  • Online ISBN: 978-3-319-56547-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation