The Process from Begining to End
What to expect?
Days of Abstinence
Should be between 2 to 3 days – no more than 5 days. Longer or shorter periods can affect all the critical parameters mentioned above, usually making them lower, and are taken into consideration by the clinician if there are abnormal parameters.
Where is your laboratory located?
Our address is 850 N. Kolb Road, Tucson, Arizona 85710 at the Gateway Wellness Center. We are on the East side of Kolb Road, South of Speedway. The building has a blue-teal sign and a bus stop out front, and is between a Dry River Pizza Co. restaurant to our South and a Northwestern Medical building to our North. The Century Gateway 12 movie theatre and Guadalajara grill are in the parking lot with Dry River Pizza Co., south of the Gateway Wellness Center. The AALC desk is in the back left of the lobby, and there is no one sitting at the desk, just a phone and a sign with directions, and picking up the phone will automatically dial the lab’s phone. If you are lost or need more specific directions from where you are coming from, just give us a call at (520) 885-2689.
Do I need an appointment for testing or procedures?
Yes. In order to provide the highest quality of testing and patient care, we test the sample in realtime and only test/process one sample at a time. This prevents mixing up of samples and/or not getting to a sample within the required time limit. We ask that you call us at (520) 885-2689 to schedule an appointment during our normal business Hours of Operation.
How do I/we collect the semen specimen?
We have a private collection room at the laboratory for collecting the sample via masturbation. This is the best method, particularly for processing or cryopreservation, as it allows for us to get started on the sample as soon as possible. If you prefer, the sample can be collected at home into a sterile collection container and delivered to the laboratory within 1 hour of collection. If collecting at home DO NOT heat or chill the specimen – this will kill or damage the sperm – just keep it at room/body temperature until you have dropped it off with us. The semen sample should be collected after 2 or 3 days of sexual abstinence with a minimal amount of lubrication, into a sterile urine collection container. A sterile collection container can be picked up from any testing laboratory, pharmacy or here at AALC and should not be opened until beginning the collection process. Masturbation is the desired means of collection as it prevents contamination by bodily fluids, and if need be, should only be accompanied by a minor amount of lubrication as it can also harm sperm. If using alternative methods of collection minimize bodily fluid exposure to the semen, as it can also damage sperm, and make note of “Other” collection method on check-in form. Make sure to collect the entire sample into the cup, and report any spills or missed portions upon delivery. Call if confused or in need of more info.
When and how will I get my results?
The results will be completed and given to the ordering physician the same day of the test and it takes most doctor’s offices 2 to 3 business days to get back to you. We cannot release results to you directly at first, as they require interpretation by a trained professional. You can request a copy of your lab report in writing at the time of check in which can be picked up in person (with valid ID), emailed or mailed. The law allows up to 30 days however they typically be released to you within ten days. If the ordering physician gives us permission then we are able to discuss any questions or concerns. Otherwise you can ask your doctor for a copy of the report.
How long after a vasectomy will it take for the semen to be clear of sperm?
Following vasectomy it is imperative that a man comes back in to have a post-vasectomy semen analysis to ensure the vasectomy worked properly. If there are no sperm seen (absolute clear) or if only a few dead sperm are seen (functional clear) then you will not have to do further tests. For some men this process of flushing the dead sperm out lasts longer and can take a couple of months before all remnant sperm have been voided from the reproductive tract. The length of time since the vasectomy and the regularity of ejaculation can effect how long it takes for the semen to be clear of sperm, and for sterility to be declared. Some men clear on their first post-vasectomy semen analysis while others require a second or even third check. If the sample does not clear, you will be asked to re-test in one month. Occasionally, sperm can linger in the ejaculate for months and in these cases a dose of testosterone can be prescribed to shut down sperm production thereby allowing the vasectomized tubes to heal fully closed. In rare cases, the connections will spontaneously reconnect (~1/2000 men) thus restoring fertility and the vasectomy will have to be repeated.
Why is it important to have more than one semen analysis done?
All of the sperm/semen parameters (count, volume, motility, etc.) can vary greatly from one semen specimen to the next per individual. A single analysis is only a “snapshot” of a dynamic process in sperm production. The time of abstinence, hydration, and even mood and comfort level can affect the quality of an ejaculate. It is best to get two or three semen analyses done to get a better picture of sperm production and quality, particularly if a parameter is flagged as being abnormal. For example, a man may have low sperm count in one semen analysis that is normal in the next. Multiple analyses provide a basis of comparison that the physician can use to determine any fertility concerns.
What hurts sperm?
Many factors can affect sperm and sperm production. Previous disease/sickness, trauma or injury to groin area, surgery, hormone levels, medical treatments, medications exposure to environmental hazards/toxins, exposure to extreme heat (such as hot tubs, Jacuzzis, saunas) or lifestyle habits (poor diet, smoking/tobacco, drinking alcohol, drugs) can all hurt sperm and the body’s ability to produce healthy sperm. If any of the sperm numbers are low, it is best to consult a physician who specializes in fertility for a complete examination and evaluation that will likely include a follow-up semen analysis. See Sperm Healthy Lifestyles for more information.
What about the boxers vs. briefs debate?
Sperm are very sensitive to temperature, which is why the testicles are located “outside” of the body in the scrotum, as opposed to women who produce gametes internally. Proper sperm production requires a temperature that is about 5 degrees cooler than body temperature, which is why the scrotum will tighten or loosen when exposed to temperature extremes (i.e. in cold temperatures, the testicles are pulled closer to the body). The ability of the testicles to move away or towards the body based on temperature can be impacted by the wearing of “brief” style underwear that always keeps the testicles close to the body. This can result in the testicles being kept at a temperature that is hotter than they prefer. While there remains debate as to the exact effect underwear choice may have, it makes sense that “boxers” allow for a more natural scrotal position and help keep the testicles at the natural lower temperature and can thus improve sperm quality. Long or frequent exposure to hot tubs/Jacuzzi/saunas/ hot baths should be avoided as well for the same reasons. Infertility experts and many studies have shown that varicoceles (enlarged veins in the scrotal area along the spermatic cord) can increase the blood flow to the testicles which increases the temperature and can reduce sperm quality. This condition is treatable and is often followed by an increase in sperm numbers and quality. A physician who specializes in infertility is the best choice to have these factors evaluated.
After a vasectomy reversal, do I need to purge out bad sperm or can we start trying to have a child right away?
Short answer: no you don’t need to purge. After you have abstained from sexual activity for as long as your physiucian has advised for the reversal surgery to heal up, there is no need to wait any longer to start having sexual intercourse to attempt to have a child. In fact, the more ejaculations a man has after he has recovered from surgery, the faster the “old sperm” will be purged out and replaced by new sperm that are being constantly produced. The cervix is responsible for only allowing strong, young sperm to enter the uterus and proceed to the fallopian tube for fertilization, and so any sperm that are older and weaker will be caught by the cervix and won’t be able to fertilize. If a sperm is able to make it to the egg and fertilize than by definition it was a strong, normal sperm. The only thing the purging does is clear out the old sperm and the degraded sperm that does not have a chance or fertilizing an egg, and increases the ratio of new sperm to old sperm in each ejaculate. Another important factor is to have sex more often when your partner is ovulating and thus at the fertile point in her cycle. Kits are available to help track a woman’s ovulation by detecting the hormone surge that proceeds ovulation.
What questions do I ask of my local lab staff where I am having my testing done?
The most important things to check on are if the sample is tested at the location of drop off or if it is transported elsewhere, and how soon the sample will be analyzed after you drop the sample off at the lab. It is very important that the sample is examined within 20 minutes of delivery to the lab or within one hour of collection. If a sample is transported to a different site, the sample will likely not be tested within this time frame. If the sample is not tested in this timeframe the results may not be reliable, as parameters such as motility can decrease with time. Also ask if they clearly describe all the normal ranges and provide comments that are easy and clear to read and understand, especially if there is an abnormal parameter. Some labs may not include the reporting method in their report and thus any conclusions about a parameter being normal or abnormal are essentially meaningless. You will also want to ask how long it takes them to release results and if there is someone that can explain them to you should you desire. Finally, ask about cost. Hospitals, reference labs and fertility clinics can do semen analyses but the price may vary dramatically. If your insurance covers fertility testing you will also want to ensure the lab is contracted with your insurance company or that they can give you the codes to submit for reimbursement.
Why is there an issue if the volume of the sample was low but the rest of the numbers were normal?
While volume is one of the three parameters that are used to calculate the most important value of Total Motile (TM), having a normal TM with a low volume is still a problem due to the buffering ability of semen. The vaginal tract is highly acidic and will kill sperm if the pH is not neutralized. Secretions from the seminal vesicles that make up about 60-75% of the ejaculate are highly basic (alkaline) which enables the semen to neutralize the vaginal pH to prevent sperm death. If the volume of the ejaculate is too low, even if the overall sperm numbers are fine, the semen will not be able to properly neutralize the vaginal acidity. Insufficient hydration, retrograde ejaculation, prostatic issues (i.e. prostatitis) or seminal vesicle issues can cause low semen volume, or hypospermia. The level of acidity/alkalinity (pH)
can also be related to semen volume and a pH below 7.0 can be indicative of ejaculatory duct obstruction.
What is male factor infertility?
Studies indicate that 35% of infertility is related to male factor problems such as structural abnormality, sperm production disorders, immunologic disorders, genetic conditions or other medically related causes. Infertility is a couples’ problem and one that must be faced as a team. It is important to evaluate both individuals. The male fertility workup begins with a comprehensive semen analysis and results faxed to your ordering physician within 24 hours of testing. A semen analysis to evaluate male factor infertility is generally the first place to start because it is quick, non-invasive and easiest to determine.