Welcome to Techno Tidbits! No, it’s not an ‘80’s dance party, just a weekly feature where I geek-out on the more granular details about fertility, assisted reproductive technology, research, and other “science-y” aspects of what we do to help make babies. We are lucky to be living in a time when scientific innovation is improving our lives faster than ever. While the rapid pace of change is helping us to constantly improve, the onslaught of information behind all the advances can be confusing and sometimes misleading.

On TTs, I hope to break down some of these ideas, processes, and techniques, cut through the hype, and get to the facts. Mainly, I just want to share some of the things that I find so interesting about this incredible field of which I am so lucky to be a part. Some of you might find this stuff boring, which is fair enough. However, to my fellow nerds, I hope you enjoy!

To kick things off, and in honor of Movember and, let’s talk about sperm!

On the most basic level, we can all appreciate that the formula for a healthy baby requires one healthy egg and one healthy sperm. While the first half of that equation may be true, natural conception actually requires millions and millions of sperm to give that egg a chance to be fertilized. So how does a man know if he’s got enough of the good stuff? Easy: we just check the semen analysis, the cornerstone of the male fertility evaluation. Before we get into the details, let’s review some very basic definitions: Sperm are the male reproductive cells. Semen is the fluid that is produced during ejaculation that contains the sperm. Most people refer to the test as the “sperm count”, but there is more to it than just that.

Since ancient times scientists have been trying to discern which qualities of a man’s mojo influence fertility. It was not until 1677 that Johan Ham first saw human sperm under van Leeuwenhoeks’s microscope, and in 1891 when Alois Lode pioneered the more scientific approach to examining semen. Numerous improvements have been introduced through the years, and the current standards for performing the semen analysis are published by the World Health Organization, now in its fifth edition. Computer assisted semen analysis (CASA) and artificial intelligence promise to further advance the field in coming years.

Here is sample semen analysis report below:

Clearly, many factors contribute to proper sperm function, but let’s start by focusing on what most experts would agree are the big three:

1. Concentration: the density of sperm in the seminal fluid, represented as millions per milliliter (106/ml). Sperms are counted under the high-power microscope using a device called a Makler chamber. The technicians don’t count every single sperm in the sample (that would take a while since most men have tens of millions of sperm per ejaculation), but rather, perform a calculation based on a representative sample.

2. Motility: the percentage of moving sperm in the semen sample. At least 200 sperm are counted in five separate high magnification fields using phase contrast microscopy, and the percentage of moving sperm is calculated from the sample population counted. The quality of sperm movement is also assessed as progressive versus total motility.

3. Morphology: the percentage of normally shaped sperm. This is the trickiest of the semen analysis parameters to properly calculate and interpret. To perform a morphology assessment, sperm are spread on a slide, stained with a dye that enhances visualization, and tallied as normal or abnormal based on their appearance. The expectation is that most sperm are abnormally shaped and cannot properly fertilize the egg. 

It is very important for the semen analysis to be performed at an experienced and accredited laboratory that will process the specimen in a timely fashion. Before I interpret any semen analysis results, I always refer to the time since collection. If more than 60 minutes has elapsed from ejaculation to analysis, the interpretation may be invalid. Producing the semen sample by masturbation in a sanitized facility adjacent to the lab will help avoid analytical delay and ensure accurate results. In BC, semen analysis is covered by MSP, and can be performed at the Novavita Laboratory or Lifelabs.

To give it your best shot, so to speak, abstaining for longer to build up the sperm inventory might seem like the logical thing to do. However, while prolonged abstinence might increase the concentration, sperm motility and morphology will likely be compromised. Best to keep the pipes clear and abstain for just 2-4 days.

Next week, we’ll discuss what a “normal” and “abnormal” semen analysis really means, and take a deeper dive into some factors that can affect sperm quality.