[Lisap2008]

One of the “god-fathers” of Andrology (male reproduction) Dr. Amann has a very valuable series of articles this month in the Journal of Andrology. Some of it is very complicated and will likely not be adopted by the physician community, without patient driven demand. If you are a TTC geek and are struggling with potential male factor infertility I would suggest you wade through the articles.

For the rest of you, the key points when it is time for sperm sample are:

1.Never accept a diagnosis on one sample! Total sperm count in one sample will be within -16% to +30% of the true value in only 50% of the men. Meaning a single ejaculate is almost worthless to evaluate if you have low sperm count or not. Three samples, will be -20% to +30% of the true value in 80% of the men. It simply isn’t that expensive overall (even at ~$200/sample) to KNOW for sure if low count is an issue or not.

2.Have the correct abstinence period. To maximize detection of men with truly low sperm production, abstinence of 42-54 hrs should be the case, with NO MORE than 64 hrs. Many physicians recommend much too long a time for abstinence for a diagnostic semen sample. In contrast, when producing a sample for a procedure for men with diagnosed low sperm numbers, wait 7 days. Men with normal sperm counts, should produce samples for procedures (such as IUI or IVF) after 3-4 days of abstinence.


3.Make sure your lab adheres to WHO guidelines, if they don’t, find another lab. There is no excuse for not using the globally accepted standards.

Make sure they give you a volume (in mls) of the ejaculate and a total number of sperm in the ejaculate (not just sperm per ml). This tells you the total number of sperm made at that ejaculation.
A useful parameter is total number of sperm in an ejaculate divided by the hours of abstinence (since the man last ejaculated)- this gives a value for testes production or output, and be compared across the three samples, even if the abstinence time is slightly different for the three samples.
Your man deserves a high quality fertility evaluation. Demand it

[*Mommy2Remington*]

Very interesting.......But good to know!! Thanks!

[MiracleMuffin]

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