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March 26, 2012New research – acupuncture improves sperm count
August 19, 2012When considering infertility, both the health of the woman and the man must be considered. The male factor – usually described as mild, moderate or severe – infertility is defined as a deviation from what is normally expected of sperm. These abnormalities are one ore more of the following: the number of sperm present, the proportion of the motile to non-motile (moving) sperm, and/or morphologically normal versus non-viable sperm.
Semen is collected after 2-5 days of abstinence. Analysis of sperm are conducted in a laboratory within 1 hour of collection. Doctors usually require analyses of sperm samples on at least 3 occasions over a 2 month period before conclusively making a diagnosis of an abnormality.
According to the World Health Organization1, the following are the normal values expected in semen analyses when testing the quality of a fertile man’s sperm.
- Seminal volume: 2.0-5cc
- Seminal pH: 7.2 – 7.8 (some say up to8.0)
- Sperm density, AKA sperm count: >20 million/cc or ≥40 million per total ejaculate
- Sperm motility: ≥50% forward-moving sperm or ≥20% total motile sperm
- Sperm morphology: ≥30% normal morphology
- Sperm vitality: ≥75% of sperm are alive
- Semen liquefaction time: <30 minutes
- White blood cells (WBC) in semen: <1 million/cc
Since 65% of the volume of ejaculate is produced in the seminal vesicles, low volume is typically associated with the absence or decrease of the seminal vesicle’s contribution to total ejaculate. Additionally, the seminal vesicles contribute alkaline (basic) fluid rich in seminal fructose to the ejaculate. So, overly acidic semen or semen poor in fructose can point to a problem in the seminal vesicles, like a blockage. A blockage in the vas deferens and ejaculatory duct should also be considered.
Overly alkaline semen (generally thought to be pH >8), is typically a sign of infection.
Upon ejaculation, semen is liquid. It later coagulates by protein kinase secreted by the seminal vesicles. After coagulation, enzymes from the prostate begin to work, causing the semen to liquify again. Delayed or absent liquefaction, can indicate a problem in the prostate, like prostatitis. If the semen doesn’t become liquid again, sperm motility will be hindered.
Low sperm sperm count, or oligospermia, is considered to be <20 million/cc and normal sperm count is considered to be >20 million/cc.
Sperm motility, ideally >50% are forward-moving, is evaluated by the following scale:
- 0 — No movement
- 1 — Movement, none forward
- 1+ — Occasional movement of a few sperm
- 2 — Slow, undirected
- 2+ — Slow , directly forward movement
- 3- — Fast, but undirected movement
- 3 — Fast, directed forward movement
- 3+ — Very fast forward movement
- 4 — Extremely fast forward movement
Sperm morphology is the next variable analyzed. This evaluates the shape of the sperm. Sperm are organized into the following categories:
- normal-oval shaped
- tapered
- amorphous
- duplicated
- immature
Sperm are considered normal when they have an “oval form with smooth contour, acrosomal cap encompassing 40-70% of head, no abnormalities of midpiece, or tail and no cytoplasmic vacuoles of more than half of the sperm head.”2. Any sperm not strictly fitting the criteria, also known as borderline sperm, are counted as abnormal. The types of abnormality are amorphous, tapered, duplicated, immature, coiled-tail, blunted-tail, or mid-piece.
The presence of some white blood cells (WBC) in ejaculate is normal. When levels of WBCs is >1 million/cc, infection should be suspected. This is called leukocytospermia. Some populations of men can have leukocytospermia without the presence of infection. A doctor should always culture semen to detect anaerobic or aerobic pathogens, including chlamydia and mycoplasma. The reason why the presence of WBCs is undesirable when trying to conceive is WBCs can oxidize sperm, making them non-viable.
Other tests you might want to ask your doctor to run are:
- Anti-sperm antibodies test
- Acrosome reaction
- Hamster egg penetration test
- Hemizona Assay
- NAAT-based detection of the pathogens
- Biochemical markers, like creatine kinase and reactive oxygen species (ROS)
- Blood test to check hormone levels, specifically testosterone, leutinizing hormone (LH) and follicle stimulating hormone (FSH)
- Imaging studies to rule out obstruction
- Post-ejaculation urinalysis to determine if there is retrograde ejaculation
- Testicular biopsy; usually done as a last resort when diagnosis cannot be determined by other means because it is so invasive
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1. WHO Laboratory manual for the examination of Human semen and Sperm-Cervical mucus interaction. Cambridge University Press, 3rd edition, 1992
2. Stonybrook University Hospital, Department of Urology
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35 Comments
Hi doctor, Please can you explain to me , what happens if the morphology of sperm normal is only of 27 %
Some abnormality in sperm morphology (sperm shape) is normal. In fact, some consider only a semen sample containing only 4% morphologically normal sperm to be within the normal limits. Abnormally shaped sperm may have a hard to time reaching the egg to fertilize it. Abnormal morphology doesn’t reflect a problem with the chromosomes contained inside the sperm. Abnormal sperm morphology may indicate a problem in sperm development in one’s testicles due to overly high temperature, exposure to toxins, infection or genetic predisposition. You should speak to your healthcare provider about the possible causes and figure out the best course of action for your specific case.
Result of my semen analysis pls suggest is it normal or do i need some treatment
Volume- 1.0ml
Colour- Greish white
Odour- Muskey
Reaction- Alkaline
Total sperm count- 34.8millions/ml
Motility- 60% actively motile
Morphology- Normal
Other cells- Pus cells 2-3/hpf
Viscosity- Highly viscous
Liquefaction time- 20min
Period since last emission- 3 days
Unfortunately, I cannot evaluate your results since you are not a patient. I suggest finding a provider locally to review your test results.
hi
sir my semen analyses shows result
volume 3.0ml
colour greyish white
viscosity non-viscouse (li.upon receipt)
liquefaction 00min
odour seminal
reaction alkaline
sperm count 0mil.ml
abonormel form o h..p.f
pus cells 25-30 h.p.f
r.b.c 18-20 h.p.f
spermatogenic cells (active selgish dead)
plz help me me so woried
Unfortunately, I can’t comment on your report or advise you directly because you’re not a patient. You can refer to my normal semen values blog post for a comparison.
sir during the ivf procedure of my wife i done my semen analysis.it was found puscells 3-4 /hpf and hyperviscid.i was undergone for an ultrasound scan also.Because of a suspicious finding of prostate infection,he told me to do culture.The result was enterococci species with ampicillin and amoxicillin sensitive,.Then i had a course of ampicillin .As per the instruction from doctor i repeated the culture again after one month.but i found the same no of pus cells(with hyperviscidity) in semen and at the same time the presence of growth in culture.My question is why my infection has not been cured even after the course of ampicillin.Is this infection is a serious one ?because i am not having symptoms for my prostatic area and not having any pain or burning micturation related with it..
thank u
Hello. I can’t advise you directly because you aren’t a patient of mine. If I had a similar patient, I would treat the prostatitis and other symptoms with herbs during the course of antibiotics. Together, the two may be able to clear up the infection. After the infection is clear, I would work on improving semen values to help boost fertility. I would not ignore the infection.
Result of my semen analysis pls suggest is it normal or do i need some treatment
Appearance normal
Ph 7.8 7.2—8.0
Total sperm concentration 80million/ml
Active motile 70%
Sluggishly motile 20%
Immotile 10%
Normal morphology 70%
Rbc(red blood cell) ————————————-nil
Pus পcell 2-3
Fat globules ————–nill
Comment: normozoospermia
Hello. Thanks for your inquiry. Unfortunately, I cannot comment on your report because you aren’t a patient of mine. You can refer to my blog post on the subject of normal values for semen analysis to compare to your results.
Physical Examination
liquefaction at 37 c = 30minutes
volume =2ml
appearance = viscid opaque
colour=whitish
viscosity=slight
ph=7.8
Microscopic Examination
total sperm concentration =60 million/ml
percentage motility =40%
Grade A =10%
Grade B =30%
Grade C =60%
Agglutination =Negative
longevity 180 minutes
pus cells 20-25/hpf
Red Blood Cells =nill
Epithelial Cells =nill
Morphology
normal morphology=60 %
abnormal morphology 40%
(a) head defects = 20%
(b) neck &midpiece 10%
(c) tail defects = 10%
Chemical examination
semen fructose qualitative =positive
pls sir meri report ka result kiya hai . mere sperm me koi kami to nahi hai. pls report answer .
I can’t comment on reports for men who aren’t patients. You can refer to my post on normal semen values on my blog: https://jinheeyooacupuncture.com/2012/08/semen-analysis-what-are-normal-values/
My Result are
Morphology: 60% normal, 40% abnormal
Motility: 10% active, 20% sluggish
Non motile: 70%
Sperm count: 48Million
PH: 7
Volume: 3Ml
Viscosity: opaque
Colour: greyish white
Read more https://jinheeyooacupuncture.com/2012/08/semen-analysis-what-are-normal-values/
I can’t evaluate your test results. I can only discuss results with patients.
sperm concentration 9 mill\ml volume 5 ml, total sperm count 45 million
motllity 50% progressive 33%
morphology normal 85%
is it normal
I can’t evaluate your test results. I can only discuss results with patients.
I did do th semens analysis with everything normal except morphology with tapered heads,11percent.i am staying south africa,what can I do?
I can’t make any suggestions because you’re not a patient. Please consider finding a local specialist. Sorry I can’t be of more help.
sir i have sent semen profile please guide me my semen profile is normal
period of abstinence->30 days
time of collection-3:20pm
time of analysis-3.40pm
volume-.05 ml
liquefaction time-20 min
odor-normal
color-grey
viscosity-normal
ph-8.0
count-36 m/cc
motility-80%
rlp-50%
sluggish-50%
immotile-20%
cellular debris-present
agglutination-nil
pus cells-1.2
normal-60%
abnormal-40%
head defects-12%
mid piece defects-20%
tail defects-08%
I can’t evaluate your test results. I can only discuss results with patients.
Amount Sent – 1oz
Color-Whitish
Viscosity-Viscous
Cell count 45million/ml
Motility-20%-25% are mortile
Morbidity-Head neck & tail are normal
Puss cells- 30-60/-
Is it normal?
Unfortunately, I cannot advise you because you’re my patient. I suggest finding a local specialist to review your results.
Sir i sent my seminal analysis report. please tell me my report is normal?
volume: 1.5 ml
Color: Whitish
pH: 7.5
Liquefaction: 30 Minutes
Count: 135 Million
Clumping: Nil
Active Motile: 70%
Sulggishly Motile: 15%
Non Motile: 15 %
Normal Forms: 82%
Abnormal Forms: 18%
White Blood Cells: 20 – 25/HPF
Red Blood Cells: 6 – 8/HPF
Unfortunately, I cannot advise you because you’re not a patient. I suggest finding a local specialist to review your results.
colour-grey,volume-4.0ml,liqui.time-10-15min,viscosity-grade(1),reaction-alkaline,pus cells-5-7/hpf,motile-70%,active motile-50%,sluggish-20%,nonmotile-30%,sperm count-35millions/ml,it is normal or abnormal.
Unfortunately, I cannot comment on your test results because you’re not a patient. I suggest finding a healthcare provider near where you live to discuss your results.
color. greyish
quantity. 3.5 ml
Liquefaction time. 20 min
pH. 7.5
total count. 0.2
active motile. 00
sluggish motile. 50
non motile. 50
pus cells. 2-3
RBC. 0-1
Plz help! My seminal analysis report
=>Physical Exmination
Volume : 1.5
Color :G.White
Viscosity : Thick
Liquefaction Time : Microscopic Examination
Active : 45%
Sluggish : 25%
Dead : 30%
Normal Sperm : 60%
Abnormal Sperm : 40%
Total Sperm Count : 35 M/ml
Pus Cells : 06—-08 /HPF
RBCs : 00—-000 /HPF
Unfortunately, I can’t discuss your report because you’re not my patient. Please talk to the doctor who ran the semen analysis or another provider you see as a patient.
hi doc,
i have done semen analysis
here is the report,,
Quatity = 2 ml
color = Greyish white
reaction = alkaline
liquifaction = 30 mts
total count = 4072 mil/ml
active motile = 70 %
sugglish motile = 10 %
non motile = 20 %
Normal form = 70 %
abnormal form = 30 %
pus cells = 2-4
R.B.C= 0-2
Epitheleial= A Few
please mail me your suggestion
thank you
Hello,
I’m not your healthcare provider, so I can’t evaluate your test results. Please speak to the doctor who did the test for an interpretation.
total 32 million.
Grey white, volume 2.5 ml, Ph 7.8
Active motile 20%
Sluggish 10%
Dead form 70%
Morphology
normal 15%
Giand head defect 30%
Pin head 10%
Long tail 25%
Short tail 15%
Double head 5%
Dr.
i check my semen analysis report and report says no liquefaction with in one hour so sir please guide me that my wife still get pregnant of not
I suggest finding a healthcare provider in your area who can help you. This isn’t something I can help with remotely.
My semen report
Qnty. 1 ml
colour white
viscosity normal
reaction ph 8.0
other NAD
SPERM 0.5 Million/c
Pus cells 15-20/hpf