Approximately 30% of men who seek fertility assistance will have an abnormal semen analysis.  Most abnormalities deal with low concentration (oligospermia), low motility (asthenospermia), or low morphology (teratospermia).  A semen analysis can be done in our andrology lab on most days of the month.  We offer testing on weekdays and two weekends out of the month and provide results on the same day.

Semen analysis can also be collected at home instead of at the clinic. Please call to get information on how to obtain a collection kit and schedule an appointment. Collecting at home will not affect the test results as long as we receive the sample within 1 hour.  For those who are unable to drop off a sample within 1 hour, we can use a home collection kit from Reprosource who can perform the analysis and forward us the results. 

An evaluation by a male fertility specialist, such as Dr. Stephen Shaban, is recommended when the semen analysis is abnormal.  Sometimes the sperm quality can be improved with treatment, and it is also important to consider that an abnormal semen analysis can be a sign of other medical problems.  When sperm problems persist, treatment such as intrauterine insemination (IUI) or in-vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) may be required.

Causes of male infertility

Understanding how the male body works to facilitate reproduction is just as important as understanding the female’s side of the story.

Perhaps because most infertility diagnoses begin with a woman’s gynecologist, most couples are unaware of the fact that the man may be the sole or contributing factor in up to half of the cases of infertility.

Male factor problems can fall into a problem with production or obstruction. Production problems can start with erectile dysfunction. If this is the case, hormonal levels for testosterone, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, and prolactin should be checked. Whether normal or abnormal we often refer men to a local reproductive urologist, Dr. Steven Shaban at Associated Urologists of North Carolina. Other problems with production may be related to testicular varicose veins, environmental exposure, and prior history of testicular or other cancer.

Obstructive issues are ones that impair the transport of sperm from the testes to the seminal ejaculate. Prior trauma or infection, surgery, failed vasectomy reversal, or congenital absence of the vas deferens are all causes of obstructive azoospermia, or lack of sperm in the ejaculate. Again, consultation with Dr. Shaban or another reproductive urologist is recommended.

Male fertility tests

The best test for male fertility is a semen analysis. At Carolina Conceptions we ask our male patients to refrain from ejaculation at least two but not greater than five days prior to submitting a specimen. The ejaculate can be produced at home and brought to the office if delivered within approximately 30 minutes after ejaculation. Appointments are available for all weekdays, as well as the first and third weekend of each month.

Semen analysis results will often be emailed back to the patient on their appointment day. If abnormal, we suggest that the process be repeated in six to eight weeks. If the sperm count is extremely low, we will ask that in addition to hormone values, he consider a chromosomal analysis which can contribute to low sperm counts in up 20% of cases.

Treatment options for male factor infertility include intrauterine insemination or in vitro fertilization with sperm injection (ICSI).

For more information about semen analysis:

Next steps

Many of our male patients have questions about how to interpret the morphology portion of their semen analysis report. If you still have questions after reviewing this page, please don’t hesitate to call us.

After the results are back from all fertility evaluations ordered by your physician, you will meet with your physician again in person or by scheduled phone consultation to review what everything means and create a treatment plan together.

Sometimes a couple tests “normal” for their fertility evaluations, yet still experiences difficulty conceiving or sustaining a pregnancy. When this is the case, we look for more answers from genetics.