It is highly recommended that the male partner in all infertile couples undergo a formal semen analysis to assess whether there is adequate sperm number and quality. The doctor may advise the man who is scheduled for semen analysis to abstain from sex for two to four days beforehand. The semen analysis should include basic parameters such as sperm number, motility, and morphology (shape). In a normal ejaculation the total volume of semen is between a half and a whole teaspoon. As part of the semen analysis, the technician will determine the number of sperm present in the ejaculate. A normal sperm concentration falls between 20 million/mL and 200 million/mL. The technician looks at how well the sperm are moving and counts the total percentage of motile sperm by figuring how many sperm per 100 are moving. At least 50% of any given sperm population should be moving. A well-developed sperm can propel itself up a woman’s reproductive tract at a rate of more than 2 inches an hour. Finally, the shape or morphology of the sperm is determined. Sperm heads should be oval-shaped without irregularities. In the event that the semen analysis is abnormal, it should be repeated, and referral to a urologist who specializes in male infertility should be considered. The evaluation of the male involves a thorough physical examination and hormonal testing. In the event that no sperm at all are found on a semen analysis, a testicular biopsy may be indicated.
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