Author: HSIEN-AN PAN MD.PHD. (also published in the China Times)

Miss Kung, who is experiencing infertility, was advised to bring her partner for a semen analysis at the clinic. However, her husband insisted on waiting until she completed all her tests and confirmed no issues before he would undergo his own examination, citing his busy work schedule. Such excuses being repeated in the clinic make one wonder if our health education and family upbringing in Taiwan are adequate.

 

Infertility should be addressed by both partners together. Only by encouraging each other and undergoing joint examinations can problems (both physiological and psychological) be solved. It is important not to always assume that the problem lies solely with oneself, as male factors account for 30-40% of infertility cases and should not be overlooked. Especially in comparison to the tests women have to undergo, semen analysis is much easier and painless for men, with the only inconvenience being abstinence for three days before the examination.

 

On the day of semen analysis, men can either collect the semen at home (within an hour's journey) or in the collection room of the reproductive medicine center. The semen should be ejaculated into a sterilized wide-mouthed cup and should not be exposed to high or freezing temperatures. It can be stored at room temperature. Normal semen appears as a milky-white, semi-coagulated substance with a volume ranging from 2 to 6 ml. After approximately 30 minutes, it should liquefy into a uniform milky-white liquid. If liquefaction does not occur within one hour, it indicates an abnormality, possibly related to the prostate.

 

After liquefaction, skilled technicians will carefully measure the volume of semen, sperm concentration, motility, morphology, presence of sperm antibodies, and the sperm's activity the following day. According to the World Health Organization's standards issued in 1992, semen volume should be greater than 2 ml, sperm count should be greater than 20 million per milliliter, sperm motility should exceed 50%, with fast progressive motility being greater than 25%, normal morphology should be over 30%, and white blood cell count should be less than 1 million per milliliter. Therefore, if any of these parameters do not meet the above standards, a repeat or even triple check is necessary for an accurate diagnosis.

 

With these examination results, the doctor will discuss the strategies and options with the infertile couple, including whether they qualify for artificial insemination (requiring open fallopian tubes and a sperm count of at least 10 million per milliliter with a motility rate of over 30%) or if they need to consider intracytoplasmic sperm injection (when the sperm count is less than 5 million per milliliter) along with embryo implantation. Therefore, sperm analysis is a crucial test for every infertile couple, and it is important for husbands to readily and openly accept this examination.