Seminal Fluid Analysis (SFA) : All you need to know

Seminal fluid analysis is a medical test done to assess the characteristics of the male semen and the spermatozoa therein. It is usually done to evaluate the male fertility or infertility, and for verifying the success of vasectomy (a permanent method of male contraception).

In this article, I will enlighten us on the common terminologies used in seminal fluid analysis and maybe give us some snippets on the interpretation of the results.

Medical Terminologies used in seminal fluid analysis

• Semen: Also called seminal fluid or ejaculate, is an organic fluid that contains spermatozoa, enzymes, fructose, and other proteolytic substances. It is produced by the male gonads . About 96 to 98 percent of semen is water.
• Spermatozoa: A very active cell contained within the semen that helps fertilize the female ovarian. It is problems with the quality and quantity of spermatozoa that negatively affects the male ability to impregnate a woman.
• Ejaculation: Ejaculationis the discharge of semen (normally containing spermatozoa) from the male reproductory tract, usually accompanied byorgasm. Problems of ejaculation are: (1) Anejaculation which is the condition of being unable to ejaculate and (2) dysejaculation is an ejaculation that is painful or uncomfortable and (3) Retrograde ejaculationwhich is the condition where semen travels backwards into the bladder rather than out the urethra. Semen for seminal fluid analysis is collected via ejaculation or otherwise.
• Collection: The process of collecting the semen for analysis from the male. It is done through masturbation, condom collection(non spermicide condoms) and epididymal extraction. Semen collection via coitus interrupts (withdrawal method) is no longer encouraged because of the high risk of contamination and part of the ejaculate may be lost. Please be aware that semen for analysis is best collected right in the lab or clinic. This is to avoid error that occurs from temperature changes or preservation during transportation.
• Sperm count: The amount of spermatozoa contained in an ejaculate. It is different from total sperm count.
• Total sperm count: It is the sperm count multiplied by volume
• Aspermia: absence of semen
• Azoospermia: absence of sperm
• Hypospermia: low semen volume
• Hyperspermia: high semen volume
• Oligozoospermia: Very low sperm count
• Asthenozoospermia: poor sperm motility
• Teratozoospermia: sperm carry more morphological defects than usual
• Necrozoospermia: all sperm in the ejaculate are dead
• Leucospermia: a high level of white blood cells in semens. It signifies an infection
• Volume: It is the amount of semen released per ejaculation. The World Health Organization says semen volume of 1.5ml to 2ml and up to 5ml is normal. Men also produce more seminal fluid after lengthy sexual stimulation and arousal. Reducing the frequency of sex and masturbation helps increase semen volume. Sexually transmitted diseases also affect the production of semen. Men who are infected with the human immunodeficiency virus (HIV) produce lower semen volume.
• Motility: Motility means movement. Motility is the ability of the spermatozoa to move towards the female ova in order to fertilize it. This is very important. Some males with fertility problems have issues with sperm motility (sluggish sperm) . The World Health Organization recommends at least 50 percent motility per ejaculate.
• Morphology: Simply means the shape of the sperm cell. It has to do with the presence or absence of defective spermatozoa. The World Health Organization recommends the spermatozoans should contain at least between 50% to 60% of normal forms.
• Colour: The colour of the semen matters a lot. According to Wikipedia, semen normally has a whitish-gray color. It tends to get a yellowish tint as a man ages. Semen color is also influenced by the food we eat: foods that are high in sulfur, such as garlic, may result in a man producing yellow semen. Presence of blood in semen (hematospermia) leads to a brownish or red colored ejaculate. Hematospermia is a rare condition. Semen that has a deep yellow color or is greenish in appearance may be due to medication. Brown semen is mainly a result of infection and inflammation of the prostate gland,urethra, epididymis and seminal vesicles. Other causes of unusual semen color include sexually transmitted infections such as gonorrheaandchlamydia, genital surgery and injury to the male sex organs.
• Fructose level: Fructose is the substance or the “energy house” of the spermatozoa. It is this energy that drives or propels the spermatozoa to the female egg. The WHO recommends an ejaculate of semen to contain 13umol of fructose. Absence of fructose or reduced levels indicate problems with the seminal vesicles.
• PH: means the acidity or alkalinity of the semen. The spermatozoa thrives in an alkaline environment of between 7.2 to 7.8.
• Vitality: A term recently introduced in seminal fluid analysis (SFA). It simply means the measurement of the number of spermatozoa that is alive in an ejaculate. The world health organization recommends that at least 75 percent of the sperm cell should be alive.
• Measurements method: Seminal fluid analysis is done with computer assisted semen analysis (CASA) and Raman spectroscopy
• Repeat SFA: Most times, the results of your first semen analysis are not encouraging and may require a repeat. If the results from a man’s first sample are subfertile, they must be verified with at least two more analyses. At least 2 to 4 weeks must be allowed between each analysis.
• Cost: Of course you don’t think SFA is free. The last patient I sent to do the test in one of the popular fertility labs in Nigeria paid #20,000 Naira. It is covered by NHIS.

Please avoid smoking, alcohol, and sexual intercourse 2-3 days before going for a SFA as these may affect the outcome of the final results .

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