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Dr. Andrew Rynne

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What does my semen analysis test report indicate?

Answered by
Dr.
Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3787 Questions

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Posted on Thu, 25 Aug 2016 in Infertility Problem
Question: Hello Doctor,

I had my last semen analysis on May 26th2016, and following are the report details:

Volume : 3ml!
Colour : Normal
Reaction : Alkaline
Liquidation : liquefied after 1 hour
Viscosity : normal
Actively motile : 40
Sluggishly motile : 30
Non motile : 30
sperm count : 60
Pus cells : 3-5
RBC s :Nil

The doctor had told me that the liquidation might not be an issue as the motility is fine . Also, to improve the motility to 50 , he had prescribed me the medicine : 'QUANTUS'. Also, he suggested me scrotum Doppler Test . The Test showed very small fraction of vericocele . so the doctor told me to have one more semen analysis and check whether there is a drop in active sperm .I case there is a drop, then the vericocele should be tackle : upon.

I did my 2nd semen analysis today , and I am really worried with the current outcome . It seems the lab guys could not check for the figures as liquidation didn't occur even after 3 hours . please find the report details of the semen analysis performed today [31-July]:

Volume : 5 ml
Colour : Normal
Reaction : Alkaline
Liquifation : Not liquifation after 3 hours

The other attributes are all nil, as they said they could not verify them.

I am on the 'QUANTUS' tablets since 1 month . Also, I have folic acid, vitamin e, vitamin C ,zincovit as supplements . After the 1st semen report I used to have detox water ( prepared by putting cucumber , lemon, ginger ,cinnamon & apple cider vinegar in water overnight and filtering it the next day , I drink 2 litres of this per day)

I am really really tensed with the current report . could you please help me out and please suggest me whether identifying the issue by doing a semen culture and having the appropriate antibiotics help . Also. Please let me know whether this could be an issue with the lab verification.

Hoping a detailed and speedy reply.

doctor
Answered by Dr. Mahesh Koregol 6 hours later
Brief Answer:
Semen infection to be treated

Detailed Answer:
Hi,

I saw your semen analysis report.

You have severe semen infection which is seen as many pus cells and also delayed liquefaction. This semen infection needs to be treated with antibiotics.

Please get semen culture and sensitivity test done to identify the organism causing infection and the antibiotics it is responsive to. You can take antibiotics accordingly.

I suggest you to stop other medicines you are taking as your rapid +sluggish motility together is 50 % which is normal. Don't take detox water also.

There is absolutely no need to operate varicocele. Operating will not make any difference.

All you need is right antibiotics.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol 2 days later
Hi doctor ,

Thanks for the reply . I gave the semen-sample once more, this time at a different laboratory, after an abstinence of 2 days. This time the report show that it got liquefied after 30 minutes. The following are my report details:

Macroscopic Examination

Volume : 2ml
Colour : Grewy WHite
Reaction :Alkaline
Viscosity : Normal
Liquification : Liquified after 30 minutes

Microscopic Examination

Fast Progressive : 10% (Ref: 25% or more with Fast)
Slow Progressive : 50% (Ref : 50% of more with slow)
Non Progressive : 05%
Immotile : 35%
Sperm Coubt/Sperm Concentration : 42 millions/ml (>20 millions /ml)

Morphological Examination

Normal Forms : 45% ( Ref : 30% or more with normal forms)
Head Defects: 30%'
Mid Defects : 05%
Tail Defects : 20%

OTHER CELLS

Pus Cells : 4-6/HPF
RBCs: 1-2/HPF

IMPRESSION : Asthenozoospermia

During my first query , I had put up my semen analysis which happened on May 26th and there were 40% actively motile & 30 % sluggishly motile sperms and there were no presence of RBC. I am confused now , was the sample collected on this sunday wrongly interpreted as they said it did not liquify even after 3 hours . Does the current decrease in motility has anything to do with the presence of Pus cells or RBCs? I sometimes feel burning sensation at my urinary tract , is it due to RBCs present?
Also , I have an awkward kind of tiredness. Anyhow , I have given the sample for culturing . The results will be available on Friday and I have my doctors appointment of Saturday .

But, here , I need your expert views and a very detailed explanation of all the aspects , as I think I will understand all the explanations that you give . Also, I want to just ask a very simple question out from the bottom of my heart : I shall be father of kid(s), isnt it?
doctor
Answered by Dr. Mahesh Koregol 7 hours later
Brief Answer:
You can father a child

Detailed Answer:
Hi,

Liquefaction of semen is mainly related to the infection of semen.Semen infection leads to delayed liquefaction.

Present report shows normal liquefaction which means infection is likely to have subsided. This is normal process that body must have healed infection seen in previous report. Anyway culture and sensitivity test will confirm if there is infection. RBC has nothing to do with this. Burning sensation could be due to infection.

Fast+Slow progressive motility is more than 50 % which is normal. I don't see any reason to worry about it.

You can easily father a baby with this report. You need to get your wife also evaluated for basic tests to confirm everything is fine.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol 30 hours later
Hi doctor ,

I have obtained the semen-culture report and following are the readings:
SEMEN C/S
Gram Smear : Pus Cell : Plenty
Bacteria : A few gram Positive Cocci Staphylococci

Sensitive Resistant

vancomycin (16 mm) Cotrimoxazole
erythromycin(18mm) Gentamicin
clindamycin(20 mm) Pencillin
ciprofloxacin(25mm)
ceftriaxone(22mm)
cefazolin(20mm)
cloxacillin(16mm)
rifampicin(30mm)
linezolid(28mm)
augmentin(18mm)
cephalexin(17mm)
amikacin(22mm)
cefotaxime(22mm)
netilmicin(25mm)
ofloxacin(25mm)
cefaperazone / sulbactum(25mm)

I have the following queries:

1. The pus cells are shown as plenty. Does it hinder in the active motility?
2.There are many things refered as sensitive , are those the medicines which can help to fight away the bacterias present & are the resisitant ones not to be taken by patient(me).

3.Last day , I had sent across the semen analysis report and the fast progressive % was very less ie 10% , whgile ideal slab mentioned was 25%. Is this reduction in motility of fast progressive sperms due to the infection. WIll it come back to normal speeds when the infection subsides.

4. How much time it takes ideally for this infection to subside & what is the correct medicine

5. From when can I expect a positive sperm analysi if I am taking in the correct medicine.

Hope you answer answer me pointwise. Thanks a lot for your help.

Waiting for your reply

Thanks & Regards
XXXXX
doctor
Answered by Dr. Mahesh Koregol 1 hour later
Brief Answer:
Antibiotics to be taken

Detailed Answer:
Hi XXXX,

1) Pus cells cause reduced Motility and are the reason for infection.

2) Maximum sensitive antibiotic is best recommended for you. Don't take resistant medicines.

3) It might take about 15 days for sperms to resume normal motility after treating infection.

4) You can expect better semen analysis after a month of treatment.

Hope your doubts are cleared.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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