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Checking Your Sperm at Home
By Leigh Ann Woodruff, February 21, 2012
SpermCheck Fertility — the first FDA-approved at-home screening test to check sperm count — is now available online through national drugstore chains and will be hitting the store shelves in April. SpermChek is an over-the-counter test to determine whether men have a normal sperm count.
So, if you're having trouble conceiving, should you rush right out and buy the $39.95 test for you or your partner? Not so fast, caution fertility doctors. You need to understand what SpermChek actually tests. Using the at-home test is not the same as having a true semen analysis performed in a laboratory.
"The test is purely a quantitative one that looks at the concentration of sperm and neglects the two other major aspects of a good semen analysis, which are the motility, the movement characteristics, and then the morphology, which is the microscopic appearance of the sperm," says Ed Marut, M.D., a fertility doctor and medical director of Fertility Centers of Illinois.
What SpermChek Actually Tests
SpermChek tests a man's sperm count and only sperm count. In approximately 10 minutes, the test will indicate if the sperm count is within "normal" range (at or above 20 million sperm per milliliter) or low, which would indicate the individual or couple should visit the doctor for a true semen analysis. A man who tests positive for 20 million or more per milliliter of semen sees a reddish line in his test results.
The average human ejaculate contains about 180 million sperm, which is 66 million per milliliter, according to Dr. Marut. He points out that, actually, the 20 million sperm per millileter parameter is actually an old cut-off, and the new one is lower. "It's been updated by the World Health Organization to a 15 million cut-off, so that means that if someone has 17 or 18 million [sperm], they're going to read that it's negative or abnormal, and they're going to unnecessarily — especially if this is early in the course of things — go in and get checked when it may not really be appropriate."
Even more importantly, a positive test result could give a couple a false since of security because it would not necessarily mean a man is fertile. Why? SpermChek does not take into account the other important sperm parameters: sperm motility (sperm movement) and sperm morphology (sperm shape and appearance). "Someone who has a normal count, but a low motility and/or a low morphology, may be quite infertile or sub fertile and would be mislead by this test that they were actually OK."
There's More to Sperm than Just Count
So what are motility and morphology?
First, a man's sperm need to be the right shape — morphology. A healthy sperm has an oval head and a long tail that can propel the sperm forward effectively. Sperm with poor morphology could have a small, large, misshapen, crooked or tapered head, which affect their ability to fertilize an egg. Sperm with tails that are doubled, curled or kinked can also have trouble fertilizing an egg. Fertile men tend to have a normal shape and structure to at least 14 percent of their sperm. A normal shape and structure to only 4 percent is considered the lower limit of fertilizing capacity.
Morphology can affect motility. To successfully conceive a child, a man's sperm must have the ability to propel itself and move forward. Sperm that don't move or are slow are unable to reach the egg for fertilization. To be considered fertile, a man must have at least 40 percent of their sperm exhibiting healthy motility.
Dr. Marut says motility and morphology can be more important than count. "I would personally rather see someone whose count was somewhat low but with good motility and good morphology than the other way around," he says. "Let's say someone has 10 million sperm, but it's 60 percent motile, and morphology is, say 15 to 20 percent, which is normal. That person, No. 1, may be able to get their partner pregnant without doing anything, and No. 2, if they're not [getting pregnant], doing inseminations is going to concentrate that sperm and deliver a higher number of those good sperm closer to where the egg ought to be."
Should You Try It at Home?
The developers of SpermChek say the at-home test was created to meet the needs of couples who are considering and just planning on starting a family, those currently having trouble conceiving and even those men who are just curious about their sperm count. And it may be a step in the right direction for the man who is extremely reluctant about seeing the fertility doctor to have has semen analyzed.
But Dr. Marut says if patients are having trouble conceiving, a true semen analysis would be much more beneficial and give them much more information — and it may be covered by insurance. "It's not a functional test like a woman using an ovulation detection kit," he says. "If a guy has a test that says he's normal, all he knows is that he's making enough sperm to trigger the test. It still doesn't tell him that he's fertile. This is really not a fertility test."