Semen Analysis
The way life starts in the human body is a source of eternal fascination. Dr. Daniel Griffin discusses how semen analysis can be a helpful diagnostic tool when it comes to reproduction.
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Learn more about Daniel Griffin, MD
Daniel Griffin, MD
Daniel Griffin, MD specialties include Reproductive Endocrinology.Learn more about Daniel Griffin, MD
Transcription:
Deborah Howell: The way life starts in the human body is a source of eternal fascination. Today, we'll take a look at how semen analysis can be a helpful diagnostic tool when it comes to reproduction. My guest is Dr. Daniel Griffin, a reproductive endocrinologist at The Women's Hospital. Dr. Griffin, welcome to you.
Dr. Daniel Griffin: Thank you so much for having me on today.
Deborah Howell: What a pleasure. So can you review the components of the semen analysis for us and tell us what you're looking for?
Dr. Daniel Griffin: Sure. So, in about 40% of couples that have difficulties getting pregnant, there is a male component to that. And the test to initially evaluate the male is a semen analysis. A semen analysis is composed of multiple parameters. The most important ones are the volume of semen that is produced, the concentration of sperm within that sample. The percentage of those sperm that are modal, so are moving normally. And then, the final area is what it's referred to as morphology, which is the shape of the sperm.
So the components, like I said, consists of really those four main things. For the volume, you are looking for at least one milliliter. The concentration of sperm, you would like to be over 15 million per milliliter. The motility you would like to be greater than 40%. And the percentage of normal-shaped sperm ideally should be 4% or higher.
Deborah Howell: And can you discuss for us the difference between a normal or abnormal assay?
Dr. Daniel Griffin: So a normal semen analysis would have, you know, patients that met all four of those criteria. You know, we're above each of those. An abnormal semen analysis would of course be the opposite, so that they would have an abnormal, you know, parameter, whether it would be one of the parameters or sometimes more than one of the parameters. And ideally, if you had a patient that had an abnormality on a semen analysis, the first thing that you would do in terms of the evaluation would be to repeat it to confirm the abnormality. And then, if an abnormality was confirmed on a semen analysis, the next step would be to do an evaluation in the male to see if an identifiable cause of the abnormality could be found and then also potentially correct it.
Deborah Howell: Sure, which brings me to the natural next question. What are the potential causes of these abnormalities?
Dr. Daniel Griffin: Sure. Well, the same things that can cause issues with female fertility are the same things that can cause issues with male fertility. So there may be hormonal things that would cause an abnormality on a semen analysis. For example, thyroid disease, elevations in a hormone called prolactin, problems with testosterone production. There may be anatomic things that could cause an abnormality on a semen analysis. For example, if a man had an obstruction in the reproductive tract or had a what is called a varicocele, which is a dilated vein within the scrotum that is associated with abnormalities in sperm production. There may be genetic things that may contribute to abnormalities on a semen analysis. And then, finally, there are sometimes lifestyle things that can cause abnormalities on a semen analysis. For example, cigarette smoking, heavier alcohol use and certain chemical exposures.
Deborah Howell: Lifestyle is just so important.
Dr. Daniel Griffin: Absolutely.
Deborah Howell: So are there medications or interventions that we can provide?
Dr. Daniel Griffin: Yeah. So, you know, this is just like anything else in medicine from the standpoint that you gear your treatment to whatever it is that you would find in the evaluation. You know, from a lifestyle standpoint, we counsel these men to, you know, if they do smoke, to try to stop smoking. We will sometimes put them on antioxidant treatment with, you know, different vitamins and other supplements which can be available.
Certainly, if there is a hormonal cause, there are medications that men can take that can help to improve their sperm production. And if it is an anatomic cause, there are procedural things which could be done by a urologist to try to help to improve sperm parameters.
Deborah Howell: Got it. So is there anything else you'd like to add to our conversation? Maybe talk a little bit about a healthy diet that might help. We haven't discussed that yet.
Dr. Daniel Griffin: It's a lot of common sense, really. You know, eating a diet that is you know, high in fruits and vegetables, trying to avoid high amounts of fat and, you know, having a diet that is, you know, balanced and rich in antioxidants. Taking even a men's daily multivitamin has been shown in studies to help both improve motility as well as morphology.
I think another important thing that patients should know is men should not take testosterone supplementation if they are trying to conceive a pregnancy. This can have an adverse effect on sperm production and so that's another important thing that I see from time to time.
Deborah Howell: Is there anything else you'd like to add to our conversation today, Dr. Griffin?
Dr. Daniel Griffin: I think when you look at least the female side in terms of fertility treatment, besides doing a male evaluation and trying to do things to improve sperm production, there are two other treatments that can be done for male infertility. One is a procedure which is called an intrauterine insemination, which is similar to a Pap smear in a woman in which there's a small catheter that had a sperm sample in it that is placed into the uterus. The idea with this procedure is you're trying to get as many sperm as close to the egg as possible inside of the body.
The other option is to do in vitro fertilization. And for male factor infertility, we would add a procedure which is called intracytoplasmic sperm injection, where they actually the embryologist would take a single normal-appearing moving sperm, and they would inject that sperm into the egg outside of the body.
And both of those treatments can have good success rate even when we have cases where we're unable to improve the sperm parameters or, you know, where somebody may still continue to have difficulties getting pregnant, even if some of those things have already been done.
Deborah Howell: Sure. Well, it sounds like you have a lot of diagnostic tools in the chest and it's been excellent speaking with you, Dr. Griffin. Thank you so much for being with us today.
Dr. Daniel Griffin: Thank you.
Deborah Howell: This is Deaconess The Women's Hospital, a place for all your life. For more information, visit deaconess.com/bivf or call 812-842-4530.
That's all for this time. Please remember to subscribe, rate and review this podcast and all the other Deaconess Women's Hospital podcasts. For more health tips and updates, please follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.
Deborah Howell: The way life starts in the human body is a source of eternal fascination. Today, we'll take a look at how semen analysis can be a helpful diagnostic tool when it comes to reproduction. My guest is Dr. Daniel Griffin, a reproductive endocrinologist at The Women's Hospital. Dr. Griffin, welcome to you.
Dr. Daniel Griffin: Thank you so much for having me on today.
Deborah Howell: What a pleasure. So can you review the components of the semen analysis for us and tell us what you're looking for?
Dr. Daniel Griffin: Sure. So, in about 40% of couples that have difficulties getting pregnant, there is a male component to that. And the test to initially evaluate the male is a semen analysis. A semen analysis is composed of multiple parameters. The most important ones are the volume of semen that is produced, the concentration of sperm within that sample. The percentage of those sperm that are modal, so are moving normally. And then, the final area is what it's referred to as morphology, which is the shape of the sperm.
So the components, like I said, consists of really those four main things. For the volume, you are looking for at least one milliliter. The concentration of sperm, you would like to be over 15 million per milliliter. The motility you would like to be greater than 40%. And the percentage of normal-shaped sperm ideally should be 4% or higher.
Deborah Howell: And can you discuss for us the difference between a normal or abnormal assay?
Dr. Daniel Griffin: So a normal semen analysis would have, you know, patients that met all four of those criteria. You know, we're above each of those. An abnormal semen analysis would of course be the opposite, so that they would have an abnormal, you know, parameter, whether it would be one of the parameters or sometimes more than one of the parameters. And ideally, if you had a patient that had an abnormality on a semen analysis, the first thing that you would do in terms of the evaluation would be to repeat it to confirm the abnormality. And then, if an abnormality was confirmed on a semen analysis, the next step would be to do an evaluation in the male to see if an identifiable cause of the abnormality could be found and then also potentially correct it.
Deborah Howell: Sure, which brings me to the natural next question. What are the potential causes of these abnormalities?
Dr. Daniel Griffin: Sure. Well, the same things that can cause issues with female fertility are the same things that can cause issues with male fertility. So there may be hormonal things that would cause an abnormality on a semen analysis. For example, thyroid disease, elevations in a hormone called prolactin, problems with testosterone production. There may be anatomic things that could cause an abnormality on a semen analysis. For example, if a man had an obstruction in the reproductive tract or had a what is called a varicocele, which is a dilated vein within the scrotum that is associated with abnormalities in sperm production. There may be genetic things that may contribute to abnormalities on a semen analysis. And then, finally, there are sometimes lifestyle things that can cause abnormalities on a semen analysis. For example, cigarette smoking, heavier alcohol use and certain chemical exposures.
Deborah Howell: Lifestyle is just so important.
Dr. Daniel Griffin: Absolutely.
Deborah Howell: So are there medications or interventions that we can provide?
Dr. Daniel Griffin: Yeah. So, you know, this is just like anything else in medicine from the standpoint that you gear your treatment to whatever it is that you would find in the evaluation. You know, from a lifestyle standpoint, we counsel these men to, you know, if they do smoke, to try to stop smoking. We will sometimes put them on antioxidant treatment with, you know, different vitamins and other supplements which can be available.
Certainly, if there is a hormonal cause, there are medications that men can take that can help to improve their sperm production. And if it is an anatomic cause, there are procedural things which could be done by a urologist to try to help to improve sperm parameters.
Deborah Howell: Got it. So is there anything else you'd like to add to our conversation? Maybe talk a little bit about a healthy diet that might help. We haven't discussed that yet.
Dr. Daniel Griffin: It's a lot of common sense, really. You know, eating a diet that is you know, high in fruits and vegetables, trying to avoid high amounts of fat and, you know, having a diet that is, you know, balanced and rich in antioxidants. Taking even a men's daily multivitamin has been shown in studies to help both improve motility as well as morphology.
I think another important thing that patients should know is men should not take testosterone supplementation if they are trying to conceive a pregnancy. This can have an adverse effect on sperm production and so that's another important thing that I see from time to time.
Deborah Howell: Is there anything else you'd like to add to our conversation today, Dr. Griffin?
Dr. Daniel Griffin: I think when you look at least the female side in terms of fertility treatment, besides doing a male evaluation and trying to do things to improve sperm production, there are two other treatments that can be done for male infertility. One is a procedure which is called an intrauterine insemination, which is similar to a Pap smear in a woman in which there's a small catheter that had a sperm sample in it that is placed into the uterus. The idea with this procedure is you're trying to get as many sperm as close to the egg as possible inside of the body.
The other option is to do in vitro fertilization. And for male factor infertility, we would add a procedure which is called intracytoplasmic sperm injection, where they actually the embryologist would take a single normal-appearing moving sperm, and they would inject that sperm into the egg outside of the body.
And both of those treatments can have good success rate even when we have cases where we're unable to improve the sperm parameters or, you know, where somebody may still continue to have difficulties getting pregnant, even if some of those things have already been done.
Deborah Howell: Sure. Well, it sounds like you have a lot of diagnostic tools in the chest and it's been excellent speaking with you, Dr. Griffin. Thank you so much for being with us today.
Dr. Daniel Griffin: Thank you.
Deborah Howell: This is Deaconess The Women's Hospital, a place for all your life. For more information, visit deaconess.com/bivf or call 812-842-4530.
That's all for this time. Please remember to subscribe, rate and review this podcast and all the other Deaconess Women's Hospital podcasts. For more health tips and updates, please follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.