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Sperm Evaluation and Testing
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 On review, many of these reports have been printed with very out of date data related to what "normal" fertility test results should be in a fertile man.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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