in this issue
Sonja Kristiansen, MD
Medical Director & co-founder
of
the
Infertility Center
of Houston, Dr. Kristiansen is double board certified in
Reproductive
Endocrinology and Obstetrics & Gynecology and
specializes in surgical and IVF procedures.
She has
advanced training in hysteroscopy, laparoscopy, and
microtubal reconstruction. She also works with
female endocrine abnormalities relating to
menstrual and reproductive development.
Quick Links...
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For most people who are hoping to get pregnant, it can
be disheartening to arrive at the tentative conclusion
that help may be needed. Men, in particular, often
have an even harder time with this realization --
especially when they think about the dreaded semen
analysis (SA).
However, patients who move forward in their diagnostic
and treatment plans without equal participation of both
partners are not maximizing their chances at pregnancy.
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The Crucial Male
The reasons for a couple's fertility problems can be the
result of either the woman, the man, or a combination
of both. In diagnosed cases of infertility, the root of
the cause can be split roughly down the middle --
about 40 percent male-factor, about 40 percent
female, and the rest attributable to both partners. This
means that proceeding with treatment of any kind
without first taking a look at the fertility status of both
partners can result in wasted time, energy, and money.
Understandably, the simple request to participate via
semen analysis can strike fear in the heart of the
average man. However, there is virtually no other
testing method to detect problems with semen or
sperm cells.
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Simple Test, Complex Results
Fertility experts and their staff strive to be as sensitive
as possible to minimize the emotional stress related to
the toughest part of the SA. Depending on where the
patient lives, the sample may be obtained in the
privacy of home and brought to the lab in a specially-
provided, sterile receptacle. It may help to keep in mind
that as professionals, we are experienced and
comfortable with responding to any related questions.
Also, some of us may have "been there, done that" on
a personal level, so we truly understand your need for
sensitivity.
It's recommended that ejaculation be avoided from 48
to 72 hours before obtaining a sample for analysis.
Also, it's sometimes necessary to conduct two different
analyses of two different samples, obtained several
days or weeks apart. This request is usually made when
there are environmental factors that we feel may have
negatively impacted a man's first SA results, for
example, current or immediately previous illness of the
patient, testing during times of unusually high levels of
physical or emotional stress, or lab error.
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While most people might think of the phrase "sperm
count" when talking about semen analysis, the truth is
that the count is not necessarily the most important
component of male fertility. In fact, even men who
show zero sperm cells in their semen sample might
indeed be producing sperm that, for several possible
reasons, are not making it through to the ejaculate. In
such cases, we'll talk with the patient about other
means of obtaining sperm cells to analyze.
The lab will look at the following factors in each sample:
- volume
- morphology (shape)
- motility (movement)
- count & concentration or density (percentage of
sperm cells in overal semen)
- coagulation, liquification factors of the seminal fluid
Each of these factors is important to fertility, some
more than others. There are treatments that can be
used to respond to problems with any of the above. For
example, intrauterine insemination (IUI) can assist in
moderate cases of poor motility and count. In vitro
fertilization with intracytoplasmic sperm injection (IVF-
ICSI) is a successful technique for men with even the
most severe cases of impaired morphology, motility,
and other subfertility factors
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More Encouragement
In the event you or your partner need more convincing
of the value of semen analysis in your efforts to
conceive, consider these facts:
- SA is the least expensive of all fertility tests.
- SA is comparatively free of invasiveness and pain
when you consider the female diagnostic tests.
- The male body is constantly working to produce
more sperm cells. So a single negative SA result could
be very positively different in future tests.
Assisted reproductive technology is highly successful in
treating for male infertility factors.
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In Closing
Struggling to get pregnant can present numerous
challenges to a couple's relationship. Once you've
reached the point of seeking expert assistance, equal
participation by both partners can result in not only a
deepening of your relationship but in a more timely and,
ultimately, successful treatment outcome. I recommend
that a semen analysis be one of the first steps in a
couple's family-building search.
As always, I and my staff are ready to respond to any
questions or concerns you have about male fertility and
related issues, and we'll do so with professional
sensitivity.
Sincerely,
Sonja B. Kristiansen, MD
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