Male factor subfertility

Question 1

Sample collection

Answer 1

Produced by masturbation with the last ejaculation having occurred 2 - 7 days previously
Analysis within 1-2h of production
Abnormal analysis repeated after 12 weeks
If persistently abnormal, examination and investigation must follow
Normal semen analysis virtually excludes male cause for infertility

Question 2

Normal values

Answer 2

Volume >1.5ml
Sperm count >15million/ml
Progressive motility >32%

Question 3

Azoospermia definition

Answer 3

No sperm present

Question 4

Oligospermia definition

Answer 4

<15million/ml

Question 5

Severe oligospermia

Answer 5

<5million/ml

Question 6

Asthenospermia

Answer 6

Absent or low motility

Question 7

Causes for abnormal/absent sperm release

Answer 7

Idiopathic - common
Alcohol, smoking, drugs (sulfasalazine/anabolic steroids) and exposure to industrial chemicals
Varicocoele
Antisperm antibodies - common after vasectomy reversal
Inadequate local cooling
Genetic factors
Infection

Question 8

Management

Answer 8

Lifestyle changes: alcohol, drugs, smoking, tight clothing
Intrauterine insemination if mild to moderate sperm dysfunction
IVF if more severe
Surgical sperm retrieval
Donor insemination