gynecology and obstetrics
Sperm Disorders
Semen analysis
Before semen analysis, the man is typically asked to refrain from ejaculation for 2 to 3 days. However, data indicate that daily ejaculation does not reduce the sperm count in men unless there is a problem. Because sperm count varies, testing ideally requires≥2 specimens obtained≥1 week apart; each specimen is obtained by masturbation into a clean jar, preferably at the laboratory site. The jar should be sterile if the sperm is to be stored. If this method is difficult, the man can use a condom at home; the condom must be free of lubricants and chemicals. If the first semen analysis is normal, a sperm disorder is highly unlikely. After being at room temperature for 20 to 30 minutes, the ejaculate is evaluated (see table Semen Analysis ). Additional computer-assisted measures of sperm motility (eg, linear sperm velocity) are available; however, their correlation with fertility is unclear. If a man without hypogonadism or congenital bilateral absence of the vas deferens has an ejaculate volume<1 mL, urine is analyzed for sperm after ejaculation. A disproportionately large number of sperm in urine versus semen suggests retrograde ejaculation. 