How to determine if a guy’s swimmers are winners
CU Advanced Reproductive Medicine Lab Director Liesl Nel-Themaat discusses the questions most frequently asked by male patients, “How is my sperm? Are they good enough? Are my swimmers winners?”
Hello. I am Liesl Nel-Themaat, the IVF lab director for University of Colorado Advanced Reproductive Medicine. We would like to answer some of the most common questions we get from patients undergoing infertility treatment.
Today’s topic is for our male patients. The one question that every male patient asks or is dying to ask but is too embarrassed to is, “How is my sperm? Are they good enough? Are my swimmers winners?”
Today, I would like to explain to you the parameters or “measurements” we use in the andrology lab to help answer that very question.
The first thing we do when we get a specimen is to look at the “macroscopic” properties.
This is basically how much fluid or semen there is in the cup, what is the consistency and if there is anything remarkable about it. Do not be worried if your cup is not filled to the brim! Most men give us less than a teaspoon, with the average being 3.7 milliliters. A volume of 1.5 milliliters or more is considered normal.
Once all of that info is recorded, it is time to look at the “microscopic” properties of the specimen, basically looking at the sperm itself. Since these little cells are about 15 times smaller than what a good human eye can see, we need a high-power microscope to examine them, hence the term “microscopic” properties.
Before the microscopic examination, let’s take a step back: What exactly are sperm, what do they look like and why do we need them? The best comparison of what it looks like is still the shape of a tadpole! This single cell, the smallest in the human body, contains all the genes that a father will pass on to his children. In addition, at fertilization, the sperm literally wakes up the egg and tells it that it is time to start dividing and create an embryo.
A sperm cell, or spermatozoan, can be roughly divided into three parts: the head, the midpiece and the tail. Each of these parts is essential for sperm to swim to the egg and fertilize it successfully. The head is for carrying the genetic information or DNA. The midpiece provides energy for the sperm to swim. And the tail serves as a propeller to drive the sperm forward toward the egg.
So, let’s start our microscopic analysis.
First, we count the sperm using a special grid, which helps us calculate the different parameters, including concentration, total cells per ejaculate, motility and total motile count.
Concentration is simply an estimate of how many sperm cells are present in 1 mL of semen. We also need the concentration to calculate the total number of sperm a patient has in his entire ejaculate.
The andrologist will count a small sample on a high-power microscope and report the concentration as million per mL. A concentration of at least 15 million per mL is considered adequate. Once we know the concentration, we can calculate how many sperm cells are in the whole ejaculate, with 39 million or more considered normal.
Next, we look at the movement of the cells. The fancy word for sperm movement is “motility,” and it tells us what percentage of the sperm cells are moving. Why is this important? Well, you can have all the sperm in the world, but without motility, they will go nowhere and will not be able to reach the egg to fertilize it.
Motility also indicates that the sperm cells are alive. Forty percent or above is considered normal motility. We also pay attention to how many of the moving sperm are actually going forward, instead of just twitching or going in circles, to make sure enough sperm will be able to reach the egg.
Total motile cells
Finally, we calculate how many total motile cells, or TMC, there are in the ejaculate. This is the functional number of sperm that have the potential to fertilize the egg, and also the number that we pay the closest attention to. We would like to see at least a total of 15 million total motile sperm.
During a diagnostic semen analysis, we also look at a few other properties, like the shape of the head, if there are other cell types present in the semen, and if the sperm are sticking together, which will make it harder to swim.
So, there you have it, the main components of a semen analysis.
I hope you have a better understanding of what makes a guy’s swimmers winners. And next time you see an andrologist, you can impress him or her by saying, “Hopefully my TMC is above 15!”