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Sperm Evaluation
One of the biggest concerns of couples involved in an infertility work up relates to the
status of the male partner's sperm evaluation. While the thorough evaluation of sperm
and sperm function should be given high priority in any infertility evaluation, we have
found from our web page interactions with patients that often times the couple are told
very little related to test results in this area. Or, in other cases, we hear of couples
being told about "high numbers" of "abnormal" sperm, or "low" numbers of "good" sperm
with little additional information about what those results mean to their chances
for conception. Other very concerned couples have sent us copies of original semen
analysis reports, having been told of "problems". On review, many of these reports have
been printed with very out of date data related to what "normal" fertility test results
should be in a fertile man. While there is no substitute for the evaluation of semen and
sperm testing results by a highly trained and specialized professional, the truth is
that many modern laboratories and even some very well qualified physicians have not kept
totally abreast of our changing understanding of sperm function, and our new and
evolving views of "fertile" sperm test results.
In our laboratory, we arrived at our "normal" values for sperm test results by closely
watching the fertility course of the many, many patients that we have tested and
followed over the years. If 60% of our male patients with sperm counts of 20 million/ml
(considered "low" by many laboratories) are able to produce pregnancies without medical
assistance, should a count of 20 million be considered "infertile"? In the 40% of men
unable to produce a pregnancy with a count of 20 million/ml, they may indeed have a
fertility problem. The point is that there are no absolutes in the area of sperm
evaluation. This is true between different laboratories, and even within the same
laboratory.
It is our opinion that sperm test results should not be presented to patients by way of
a five minute telephone conversation. Instead, we feel each couple is entitled to sit in
consultation with their physician or nurse or Laboratory Director and be advised of the
specific results, and how those results compare to the results of known fertile males
tested in that laboratory. Couples should also ask and be told about how the "Normal"
ranges for the individual laboratory were established. There are, of course, many more
things to be elicited from the laboratory, but we feel this to be a good starting point.
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