Friday, 28 February 2014
Many people still believe that infertility is primarily a problem in the woman. This is not true and 50% of the time a problem can be identified in the male partner either in isolation or along with a female contributory cause. Therefore the couple should always be investigated simultaneously. I have had couples who insist on having the woman investigated first, to the extent of having even painful surgeries to ensure that everything is "normal" before the husband relents to having a semen analysis. This is most unfortunate and apart from ignorance there is a morbid psychological fear (that there may indeed be a problem with their semen) in some men that may be responsible for this behaviour.
A fact that is not well known is that we do not have an adequate test that REALLY tests fertility of the man. Yes, we do have semen analysis and we can check how many sperms are present, how many of these are motile and what percent of the sperms have a normal shape. There is a wide overlap in the findings of semen analysis between fertile and infertile men. And the fact remains that just by looking at a semen analysis report no one can say with certainty whether that man is fertile or nor. Of course the exception to this is when there are no sperms at all!
Sperm parameters (i.e., count, motility and morphology) also fluctuate widely and therefore if there are any concerns, the doctor will ask you to repeat the test. It is extremely important that the entire ejaculate is collected. It is the first part which is sperm-rich and in the event where the first few drops are lost, the analysis may be abnormal.