In contrast to most other body secretions examined for the purpose of diagnosis or follow-up of treatment, the ejaculate is a heterogeneous mixture of secretions that does not exist within the body before being expelled. The ejaculate is produced from a concentrated suspension of spermatozoa, stored in the paired epididymides, mixed with, and diluted by, primarily the prostatic fluid in the urethra, followed by the emptying of the secretion of the seminal vesicles. Thus, the sequential ejaculate fractions are not equally composed. Comparison of pre- and post-vasectomy ejaculate volume reveals that about 90% of the volume is composed of secretions from the accessory organs, mainly the prostate and seminal vesicles, with minor contributions from the bulbourethral (Cowper’s) glands and epididymides.
There is some evidence that the total volume and the content of spermatozoa of ejaculates vary depending on the circumstances under which the ejaculate is produced. Ejaculates produced by masturbation and collected in containers in a room near the laboratory can result in lower yield than those recovered from nonspermicidal condoms used during intercourse at home. This difference may reflect a different level and duration of sexual arousal, since the time spent producing a sample by masturbation also influences the ejaculate volume and contents.
Under given conditions of collection, ejaculate characteristics depend on factors that usually cannot be modified, such as sperm production by the testes, accessory organ secretions and recent (particularly febrile) illness, as well as other factors, such as ejaculation abstinence, that should be recorded and considered in interpreting the results.
Key patient factors influencing the ejaculate will include:
→ The size of the testicles, which influences the total number of spermatozoa produced per day and thereby indirectly output per ejaculate. Testicular size reflects the level of spermatogenic capacity, which is also related to sperm morphology.
→ Endocrine status
→ Medications the man is taking. For instance, the transport of spermatozoa from the epididymides to the urethra depends on the activation of alpha-1 receptors in smooth muscle cells in the vasa deferentia. Treatment with alpha-blockers (anti-hypertensive drugs and symptomatic treatment of prostate hypertrophy) or selective serotonin reuptake inhibitor (SSRI) antidepressants (e.g. sertraline, fluoxetine, amitriptyline) can inhibit vas deferens motility and also accessory sex gland emptying.
→ Supplements or non-prescribed medications such as anabolic steroids. These variable and largely uncontrollable factors contribute to the well-known variation in semen composition among individuals. There is evidence that the results of one single ejaculate examination are enough to decide subsequent steps of an infertility investigation of the man. On the other hand, to define an exact baseline for an individual, it can be necessary to examine two or three ejaculates. While measurements made on the whole population of ejaculated spermatozoa cannot define the fertilizing capacity of the few that reach the site of fertilization, ejaculate analysis nevertheless provides essential information on the functional status of the reproductive organs of the individual. All aspects of ejaculate collection and examination must be assessed using properly standardized procedures if the results are to provide reliable – that is, valid and useful – information.
References:
WHO laboratory manual for the examination and processing of human semen, Sixth edition, 27 July 2021, Manual [L]
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A low semen volume, also known as hypospermia, can signify various underlying factors and may have implications for male reproductive health. Here's what it can signify:
→ Reduced Fertility: One of the primary concerns associated with low semen volume is reduced fertility. Semen carries and nourishes sperm, and a decreased volume may result in fewer sperm being available for fertilization, potentially leading to difficulties in achieving pregnancy.
→ Seminal Vesicle Issues: Semen volume is primarily derived from the seminal vesicles. Therefore, a low volume may indicate issues with these structures, such as absence or hypoplasia (underdevelopment), which can contribute to a reduced ejaculate volume.
→ Fluctuations in Volume: It's important to note that the volume of semen can naturally fluctuate from one ejaculation to another. Occasional low semen volume may not necessarily indicate a problem, as this can be influenced by factors like hydration, frequency of ejaculation, and overall health.
→ Medical Conditions: In some cases, low semen volume could be associated with underlying medical conditions or hormonal imbalances, such as low testosterone levels. It may also be linked to aging in some individuals.
→ Treatment Options: If low semen volume is a concern, individuals should consult a healthcare professional for a proper evaluation. Depending on the underlying cause, treatment options may include addressing any medical conditions, lifestyle changes, or assisted reproductive techniques for fertility issues.
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If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we do talk about popular labs, we welcome reports from lots of other places too. It's as simple as this: if you can get a test done, you can upload it to Healthmatters. We can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
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Abstinence, Active sperm, Active sperm (10e6/ml), Amplitude of lateral hunting (ALH), Appearance, Average moving, Class A (fast), Class B (middle), Class C (slowly), Class D (slowly or not moving), Deformity rate, Density, Density of a+b, Liquefaction status, Liquefaction time, MAR-test IgA, MAR-test IgG, Morphology - leucocytes, Morphology - Round cells, Motility, Motility - immotil, Motility - not Progressive, Motility - Progressive, fast (A), Motility - Progressive, slow (B), Motility in fast rectilineal movement, Motility in rectilineal movement, Percent of a+b, pH, Semen pH, Seminal Fructose, Seminal neutral glucosidase, Seminal Zinc, Sperm concentration (density), Sperm count, Sperm density in fast rectilineal movement, Sperm density in rectilineal movement, Sperm morphology, Sperm motility, Sperm number in fast rectilineal movement, Sperm number in rectilineal movement, Total Motile Count, Total number, Velocity of active path (VAP), Velocity of curved line (VCL), Velocity of straight line (VSL), Viscosity, Volume, Volume of Semen / Ejaculate Volume
