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DISCLAIMER: All wallpapers and backgrounds found here are believed to be in the "public domain". Many couples overreact to the results of a single semen analysis, just as Michael and Shelley T. If the semen analysis suggests that the man is fertile and free from infection, no further fertility testing is usually needed of him.
Before I could evaluate the validity of Michael's semen analysis results, I needed to find out how he and Shelley had collected the sample. Using on-site facilities ensures that you collect the sample in a sterile container, that you do not expose your sample to temperatures above 80 degrees Fahrenheit, and that your sperm don't deteriorate from remaining in seminal plasma for more than an hour.
Michael assured me that he had brought the specimen to the office within an hour: "Your nurse suggested that since we live so far away we get a motel room down the street. Since Michael T.'s religious beliefs forbade masturbation (that's actually why he refused testing with their previous doctor), I provided him with a Mylex condom to fit around his penis during sex.
If a man is unable or unwilling to collect a semen sample, I can examine the wife's cervical mucus several hours after unprotected intercourse.
Your sperm must be able to swim to the egg with a vigorous straight motion (motility, forward progression). Your sperm must be able to penetrate the egg to deliver your genes for fertilization (sperm penetration). World Health Organization guidelines say a normal sperm count consists of 50 million sperm per ejaculate with 50 percent motility and 60 percent normal morphology (form). It's interesting to note that only twenty-five years ago counts of 100 million sperm per ejaculate were the norm. The most common way of dealing with persistent coagulation or high viscosity is collecting your sperm through masturbation, washing the semen from them, and using your sperm for artificial insemination (AIH). A microscopic examination will tell me if your sperm are clumping together (agglutinating). A normal-looking sperm has an oval head and a tail seven to fifteen times longer than the head. Too many underdeveloped or immature sperm (germinal cells) in your semen indicate testicular stress from illness or infection. If I find small testicles, scant pubic hair, or a thinning beard, I will run blood tests to confirm a hormonal deficiency. I perform the postcoital test war the middle of your wife's monthly cycle (when she should be most fertile). When I examine her cervical mucus, I look for three things: (1) if you delivered good quantities of sperm to her cervix, (2) if your sperm are vigorously swimming through the mucus in one direction, and (3) if white blood cells are present, indicating infection in either partner.
Even though the postcoital test provides very valuable information, I cannot substitute this test for a semen analysis, which gives me a better picture of morphology 'and the presence of infection (white blood cell count).
If I find no sperm in the cervical mucus, as I did with Michael and Shelley T., I suspect a deliverer problem. I remember one man who had a great sperm count but no sperm at all showed up in their postcoital test.
If I find agglutinated (coagulated) semen that contains shaking sperm instead of actively swimming sperm, I suspect that something in the mucus is attacking the sperm.
Using a condom during sex can sometimes reduce a wife's sensitivity to her husband's sperm.
Some people do not want to wait as long as a year for the possibility that her antibodies will decrease.
Sometimes I can improve the quality of your semen without having to diagnose and treat an underlying fertility problem.
Centrifuging your semen and using the more concentrated Portion for AIH may also improve your semen quality. Unfortunately, collecting and freezing several sperm samples will not increase sperm quantity and concentration.
Many methods are available to separate the sperm from the semen and concentrate them before performing an insemination. In the past the understanding and treatment of male fertility lagged far behind that of female fertility. Many times I've heard my patients say, "I had a low sperm count, so the doctor gave me Serophene. Evaluating male fertility can be time-consuming and frustrating because sperm take approximately ninety days to form and mature.
With the advent of inn vitro fertilization techniques, we're seeing rapid advances in male fertility, diagnosis and treatment.
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Other factors that might impair his sperm are incompatibility between his semen and his wife's cervical mucus or an inability to bind to the egg and fertilize it.
I don't recommend using jars washed in a dishwasher, since they contain harmful soap residue. I cautioned him not to use an ordinary condom or lubricants, since they often contain sperm-killing chemicals.

The sperm penetration assay (hamster test) or acrosin test will tell me if your sperm can penetrate the egg for fertilization.
If the volume is too small, say under one milliliter, you may not have enough fluid to bring the sperm in contact with your wife's cervix (the entrance of her womb). We know that for 90 percent of men, the first portion of their ejaculate is richest in sperm. If your coagulated semen does not liquefy within an hour of ejaculation, your sperm may be trapped in the cottage cheese-like jelly. I've seen a number of semen samples where the sperm orient themselves tail-to-tail or head-to-head instead of swimming in a straight line. You can identify defective sperm by their large heads or strange tails - kinked,, doubled, or coiled. However, considering the rate at which your production line operates ten million to fifty million new sperm per day some attrition should be expected. I remember one young athlete who had recently recovered from a case of the flu where he'd run a 104-degree temperature for three days straight.
I will want to check both you and your wife for infection, since these diseases are easily passed back and forth between sexual partners. If your semen contains white blood cells and other cellular debris, you probably have an infection, which should respond well to antibiotic therapy.
Chapter 8 discusses when varicocoele repair or hormone replacement therapy is a waste of time and money and when it will work wonders. The first barriers your sperm encounter are her highly acidic vaginal fluids and cervical mucus The vaginal environment does a good job of keeping bacteria under control, so in that way it's beneficial. At the time of ovulation her cervical mucus, which normally seals her womb from the outside, becomes thin and watery to allow your sperm to swim through the cervix toward her waiting egg.
Assuming your semen analysis was normal, if I find immotile, clumped, or dead sperm in the mucus, I'll suspect that your sperm and your wife's mucus are incompatible. Perhaps, the husband is ejaculating prematurely and not depositing the sperm near her cervix.
After counseling with him, I discovered that when he had sex he faked his climax and did not ejaculate. Vaginal lubricants or allergic responses to the sperm can also cause this toxic reaction; for example, the woman's immune system may be producing antibodies that are attacking the sperm. If she avoids all contact with her husband's sperm - hands, her mouth, her genitals, and so forth - for three months or so, her antibodies may decrease in numbers.
So usually I use artificial insemination with the husband's sperm to bypass sperm-mucus interaction problems. Concentrating your sperm by natural means or in the laboratory may improve your semen quality enough so that your wife can get pregnant without expensive medications and surgeries. The freezing and thawing processes damage the sperm so severely that semen quality actually diminishes. Techniques such as percoll, swim-up, swim-down and sedimentation procedures are helpful for in vitro fertilization, they are usually not necessary for insemination.
Chapters 7 and Chapter 8 explain how I can identify the causes of your problem and outline a fertility treatment plan. He said if that didn't work, we'd try Metrodin." When I asked them if their doctor ran tests to find out why the sperm count was low, more often than not they said no. So if your doctor does something today to enhance your sperm production, it may be ninety days before the improved sperm show up in your semen sample.
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However, since many factors can "spoil" or influence a single test result--errors in collection, errors in handling the specimen, and errors at the laboratory I'll always advise performing a second semen analysis in a month or so.
Problems with sperm-mucus interaction can be checked by doing a postcoital test which I'll describe. For example, if you ejaculate infrequently, your sample will contain a higher than expected number of dead sperm and sloughed-off cells. It's extremely important that you collect the entire specimen because the concentration of sperm varies in different portions of your ejaculate. Although Shelley complained of some discomfort with the loose-fitting plastic pouch, they both found this procedure more acceptable and were able to collect a complete sample.
Under ordinary circumstances, however, the postcoital test does not give me as much information as the semen analysis, because I cannot evaluate the percentage of deformed sperm or take a white blood cell count to test for infection. It's possible that your bladder sphincter muscle, which normally directs your semen out through your penis, is not closing. Provided your sperm show adequate forward motility and good egg penetration, concentrations as low as 5 to 10 million can produce a pregnancy. In addition, an insufficient quality of protective semen will expose your sperm to the acid, sperm-killing environment of her vagina. So if you produce too much semen, I'll suggest that you collect an ejaculate by masturbation. This clumping prevents them from swimming through the cervical mucus to the egg and attaching if they get there.

The World Health Organization says good quality semen should contain 60 percent normal sperm morphology.
Sexually transmitted infections such as gonorrhea and ureaplasma respond to doxycycline, a tetracycline derivative.
I will also ask if you are using medications or "street" drugs like marijuana, which can impair sperm motility. If the test is done 'at the "wrong" tine of her cycle, the results will be abnormal, since before rand after ovulation the mucus becomes impervious to sperm. After several months of counseling (costing far less than fertility treatment), he and his wife returned for another postcoital evaluation and all looked well. A repeat postcoital test at three-month intervals will tell me if this procedure is working. It's interesting, however, that sperm from a fertile donor does not deteriorate from freezing as much as that from an infertile donor. Most of these procedures select only a small percentage of the moving sperm so I usually have many fewer sperm than after a simple centrifuging sperm procedure. Without ever undergoing a thorough diagnosis, most men received a random series of treatments. All you need to do is help us grow by sharing this Emma Watson Great Quality Normal 1920×1440 wallpaper if you like it. Hamster-egg penetration tests, zona binding tests or in vitro fertilization can tell me if the sperm can function properly when it reaches the egg. If you ejaculate very frequently (for example, once a day), you may not have time to replenish your sperm supply between emissions. I try to circumvent these obstacles as best as possible without seriously jeopardizing the integrity of the test. For 90 percent of the male population, the first squirt (ejaculate fraction) contains more sperm than later portions. Where religious beliefs forbid the use of contraceptive devices, inserting a small hole near the top of the collection pouch will satisfy the patient's objections and provide an adequate specimen. I can then concentrate the sperm and place them inside the uterus, intrauterine insemination (IUI). Since the prostate gland secretes the chemical required for liquifaction, I did a rectal examination to check his gland. This finding may indicate a problem with sperm antibodies or the presence of a bacterial infection. Prostate infections, which can be especially stubborn to treat, may take a month or more to clear up. The postcoital test will tell me if your sperm are getting to your wife's uterus in good shape and in adequate members. I find this among men with frequent genital infections and with men who have undergone a vasectomy reversal. Therefor, you should insist on getting an accurate diagnosis and treatment for a known problem. However, if his semen analysis indicates a fertility problem, further evaluation is necessary. Altering your normal pattern just to perform the test either sooner or later can distort the results. If the specimen is collected at home and delivered within one hour, we should be able to evaluate sperm quality.
If the semen remains coagulated, it traps your sperm and prevents them from swimming to the egg.
When I checked the husband's semen, I found a low semen volume and a depressed sugar (fructose) level. I remember one man who transferred to a different job at his company so he could avoid exposure to heat from a blast furnace and began taking 1000 mg of vitamin C each day.
These results are pretty impressive when you consider the aim—the creation of a new human life. If the "home" results are abnormal, the test must be repeated to determine whether the sample was damaged in transit.
For these reasons, you cannot collect a good sample by withdrawing your penis during sex and taking a sample of remaining squirts. Since the seminal vesicles (glands that produce most of the seminal fluid) produce this sugar, I suspected an obstruction or infection. So, I recommend having intercourse that evening and checking the cervical mucus early the next morning. When semen volume cannot be increased, artificial insemination (AIH) provides excellent results by delivering concentrated sperm to the womb.

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