sperm tests need clarification please
4 Replies
kate - January 18

hi, dh ad I have been ttc for 3 years, he 42 me 33. I got my blodwork results back and all seemed ok. Dh got SA tests today. i could not be there and DH is not too sure what results mean. GP was not very clear in explanation. his results were as follows
volume 2.20mls, density 13 million,motility 18% rapid,27%medium,15%low.
morphology was 6% and poor swim up.
how bad is this? DH has to go back for another teast in 2 months.

Thanks so much in advance ladies, this forum is so suportive


Ann - January 18

Here is some info about normal counts:

What is a normal sperm count ?

If there are enough sperms. If the sample has less than 20 million sperm per ml, this is considered to be a low sperm count. Less than 10 million is very low. The technical term for this is oligospermia (oligo means few). Some men will have no sperms at all and are said to be azoospermic. This can come as a rude shock because the semen in these patients look absolutely normal - it is only on microscopic examination that the problem is detected.

What is normal sperm motility ?

Whether the sperms are moving well or not (sperm motility). The quality of the sperm is often more significant than the count. Sperm motility is the ability to move. Sperm are of 2 types: those which swim, and those which don't. Remember that only those sperm which move forward fast are able to swim up to the egg and fertilise it. The others are of little use.

Motility is graded from a to d, according to the World Health Organisation (WHO) Manual criteria , as follows.
Grade a (fast progressive) sperms are those which swim forward fast in a straight line - like guided missiles.
Grade b (slow progressive) sperms swim forward, but either in a curved or crooked line, or slowly (slow linear or non linear motility).
Grade c (nonprogressive) sperms move their tails, but do not move forward (local motility only).
Grade d (immotile ) sperms do not move at all.

Sperms of grade c and d are considered poor. If motility is poor
( this is called asthenospermia) , this suggests that the test is producing poor quality sperm and is not functioning properly, and this may mean that even the apparently motile sperm may not be able to fertilise the egg.

This is why we worry when the motility is only 20% (when it should be at least 50%) Many men with a low sperm count ask is - " But doctor, I just need a single sperm to fertilise my wife's egg. If my count is 10 million and motility is 20%, this means I have 2 million motile sperm in my ejaculate - why can't I get her pregnant?" The problem is that the sperm in infertile men with a low sperm count are often not functionally competent - they cannot fertilise the egg. The fact that only 20% of the sperm are motile means that 80% are immotile - and if so many sperm) cannot even swim, one worries about the functional ability of the remaining sperm. After all, if 80% of the television sets produced in a factory are defective, no one is going to buy one of the remaining 20% - even if they seem to look normal.

What is normal sperm morphology ?

Whether the sperms are normally shaped or not - what is called their form or morphology. Ideally, a good sperm) should have a regular oval head, with a connecting mid-piece and a long straight tail. If too many sperms are abnormally shaped (this is called teratozoospermia, when the majority of sperm have abnormalities such as round heads; pin heads; very large heads; double heads; absent tails) this may mean the sperm are functionally abnormal and will not be able to fertilise the egg. Many labs use Kruger "strict " criteria (developed in South Africa ) for judging sperm normality. Only sperm which are "perfect" are considered to be normal. A normal sample should have at least 15% normal forms (which means even upto 85% abnormal forms is considered to be acceptable !)


kate - January 18

thanks Ann, i am hoping that my dhs SA will improve by next time. I feel really that we will need to move towards IVF but am dreading this. THanks again for all the info and best wishies to you


Ann - January 18

I know what you mean about being hesitant to move on to IVF. We have "unexplained" infertility and I am 36, so I am afraid that will be recommended to me soon (already done 3 iuis and 4 rounds of clomid). Are you seeing a RE? If I were you, I would make an appointment ASAP if you are not. You can go to a fertility center to get help for your dh as well. A question you should ask when you call is whether the team includes an andrologist and reproductive urologist. Hopefully, your dh has an issue that can be corrected. Good luck!


Leilani14 - January 19

Honestly these are not good results, My DH had almost the same numbers when we started TTC. My advice would be that he starts vitamns right away, they can't hurt, even doctor can't believe that vitamins are responsible for my DH improvement I believe they are. Remember there is hope, we concieved naturally 6 months after the first SA.



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