Sperm & semen health
Sperm are produced and matured in the testicles, in a process known as “spermatogenesis.” The testicles make several million sperm per day—about 1,500 per second—that is released in a fluid called semen (also produced in the testicles). Healthy sperm can travel through the vagina and uterus and into the fallopian tubes to fertilize an egg.
Elements of sperm and semen health include:
- Volume: The overall amount of semen (too little could indicate a blockage)
- Chemistry: The pH, viscosity, and chemical makeup of the semen
- Concentration: How many sperm are present per milliliter of semen, often loosely referred to as the “sperm count” (ideally 15–20 million per milliliter, or more)
- Motility: The percentage of sperm that are “swimming”—ideally 40–50% or more are motile
- Morphology: What percentage of sperm are the proper size and shape to penetrate an egg (ideally at least 4%)
- Genetic health: Like eggs, sperm can have genetic abnormalities that make them unable to create a healthy embryo
Factors affecting sperm & semen health:
Age, genetics, illness, male hormone imbalance, anatomical problems, environmental factors, medical history, lifestyle factors
Age is not only a factor for eggs. While men have no risk of “running out” of sperm with age, studies show that increasing male age is associated with decreased sperm motility, morphology, and seminal volume, and increased time to pregnancy and decreased pregnancy rates, especially for men over 40–45.
Sperm health is influenced by lifestyle, medical, and environmental factors, such as smoking, illness, obesity, or toxin exposure. The good news is that, because sperm are constantly being regenerated, removing the negative influence can often lead to an improvement in sperm or semen health.
Test for sperm & semen health:
Semen analysis
Possible treatments:
Referral to a urologist to diagnose and treat the underlying issue
Intrauterine insemination (IUI)
IVF with intracytoplasmic sperm injection (ICSI)
Sperm freezing
Donor sperm
Ejaculation
In couples with a male partner, semen and sperm are typically released through sexual intercourse and ejaculation. So, while not exclusively a “fertility issue,” a problem with sexual intercourse or ejaculation—such as retrograde ejaculation (when semen enters the bladder during orgasm instead of emerging out the tip of the penis), erectile/ejaculatory dysfunction, or painful intercourse—can impact a couple’s ability to get pregnant naturally.
Possible treatments:
Referral to a urologist to treat the underlying issue
Surgical sperm extraction such as TESE or MESA
Intrauterine insemination (IUI)
IVF with intracytoplasmic sperm injection (ICSI)
Electro-ejaculation (EEJ)
Sperm freezing
Donor sperm