Common Causes of an Abnormal Semen Analysis and How to Address Them

• November 22, 2024
• Dr Luke Wee

Last updated on November 15, 2024

A semen analysis is a crucial test in evaluating male fertility. By examining various aspects of a semen sample, including sperm count, sperm motility and sperm morphology, healthcare professionals can identify potential issues that might affect fertility. An abnormal semen analysis can be concerning, but understanding the common causes and addressing them effectively can improve outcomes.

What is a Semen Analysis?

A semen analysis involves examining a semen sample to assess factors such as sperm concentration, semen volume and sperm motility. The test looks for abnormalities in the sperm cells, including sperm shape and movement, which can provide insight into male infertility.

In a typical analysis, a semen sample is collected and tested for factors like sperm count, the presence of white blood cells and the percentage of motile sperm. Normal sperm are usually uniform in size and shape, with a proper head and tail, while abnormalities may indicate potential fertility issues.

Common Causes of an Abnormal Semen Analysis

1. Low Sperm Count (Oligospermia)

Low sperm count, or oligospermia, is one of the most common findings in an abnormal semen analysis. Factors that can lead to low sperm counts include hormonal imbalances, lifestyle habits such as smoking and excessive alcohol consumption and medical conditions like varicocele (enlarged veins within the scrotum).

Sperm production can also be negatively affected by stress, obesity and certain medications. Low sperm count can significantly affect fertility, reducing the chances of natural conception.

2. Poor Sperm Motility (Asthenospermia)

Sperm motility refers to the ability of sperm cells to swim efficiently towards the egg during sexual intercourse. Poor motility, or asthenospermia, can result from various factors, including infections, oxidative stress and exposure to toxins. Inadequate movement of sperm can prevent them from reaching and fertilising the egg, leading to challenges with male fertility.

3. Abnormal Sperm Morphology (Teratospermia)

Sperm morphology refers to the size and shape of sperm cells. Abnormally shaped sperm, or teratospermia, can affect fertility as they may be less capable of fertilising an egg. Sperm morphology abnormalities can be caused by genetic factors, exposure to toxins, or certain health conditions. An abnormal semen analysis often reveals a high percentage of sperm with irregular shapes, affecting the overall quality of the semen sample.

4. Low Semen Volume

Semen volume plays a vital role in fertility, as it aids in transporting sperm during sexual intercourse. Low semen volume can result from blockages in the reproductive tract, hormonal imbalances, or conditions like retrograde ejaculation, where semen is directed into the bladder rather than being expelled during ejaculation. Low semen volume may also indicate issues with the accessory glands, which contribute to the fluid part of semen.

5. Presence of White Blood Cells (Leukocytospermia)

The presence of white blood cells in a semen sample, known as leukocytospermia, can signal an infection or inflammation in the reproductive tract. An elevated count of white blood cells can damage sperm cells and impair their function, contributing to abnormal sperm findings in a semen analysis.

How to Address Abnormal Semen Analysis Results

1. Lifestyle Changes

Making positive lifestyle changes can significantly improve semen quality. Reducing alcohol intake, quitting smoking, maintaining a healthy weight and managing stress can help improve sperm production and increase sperm counts. Regular exercise and a balanced diet rich in antioxidants are also beneficial for sperm health.

2. Medical Interventions

Certain medical treatments can address specific causes of abnormal semen analysis. For example, hormonal therapy may be prescribed for hormonal imbalances affecting sperm production. Surgical interventions, such as varicocele repair, can improve sperm counts and motility in affected individuals.

3. Assisted Reproductive Techniques

In cases where natural conception is challenging, assisted reproductive techniques like intracytoplasmic sperm injection (ICSI) can offer a solution. ICSI involves injecting a single, healthy sperm directly into an egg, increasing the chances of successful fertilisation, especially when sperm motility or morphology issues are present.

4. Consulting a Specialist

It is crucial to consult a fertility specialist for personalised advice and treatment options. A thorough evaluation can identify the underlying causes of abnormal semen analysis results and guide the most appropriate course of action.

When to Seek Help

Men experiencing difficulties with conception or those with known risk factors for male infertility, such as low sperm counts or abnormal sperm morphology, should seek professional guidance. Early intervention can make a significant difference in addressing fertility issues.

Conclusion

An abnormal semen analysis can reveal various factors that may affect male fertility, such as low sperm count, poor motility and abnormal sperm morphology. By understanding these causes and implementing lifestyle changes, medical interventions, or assisted reproductive techniques like ICSI, many men can improve their chances of successful conception. Consulting a fertility specialist is the first step towards understanding and addressing the underlying issues affecting semen quality.

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Frequently Asked Questions

How is a sperm sample collected for a semen analysis?

A sperm sample is typically collected through masturbation into a sterile container. It is important to follow the clinic’s instructions for sample collection to ensure accurate analysis.

What does it mean if there is no sperm present in the semen sample?

If no sperm is present in the semen sample, it may indicate a condition called azoospermia, which could be due to issues with sperm production or a blockage in the reproductive tract. Further testing is usually required.

Can lifestyle changes improve abnormal semen analysis results?

Yes, adopting a healthier lifestyle by reducing alcohol intake, quitting smoking, managing stress and maintaining a balanced diet can enhance sperm production and improve semen quality.

How often should semen analysis be repeated after treatment?

Semen analysis is typically repeated every 2-3 months to monitor changes in sperm count, motility and morphology, as sperm cells take approximately 74 days to mature.