Doctor, if the reports are abnormal do I have a chance of getting pregnant?

One peculiar thing in semen analysis is, unlike in haemoglobin or WBC count or RBC count, there are no normal values in semen analysis, there are only reference values. That means when a count is out of this range it means probably this couple will take more time to conceive. But it will not tell that the couple will not conceive if the report is abnormal. Because it also depends on women’s fertility. If the woman is highly fertile and the man is sub-fertile, still pregnancy happens. So the abnormal report needs a second validation based on the severity. Sometimes it will need added technology and advanced treatments but no need to worry if a single parameter abnormality is present unless it is a significant type of particular problem and is present in more than one report. 

Only then, it can be considered abnormal. For example, if the count is less than 20 million or some other report says less than 15 million. Depending on the WHO classification, we say it is oligospermia. There it does mean the couple will not conceive. It only says that in a given period, like a couple of years, these people might have difficulty. It also depends on how long the couple has been married. If the couple are married for 5 years and they have an abnormal report, this has a lot of importance. When it comes to motility, apart from the count, motility abnormality has more importance than only their count. If the motility is low it shows there is a structural and functional abnormality probably. And when it comes to quality. abnormal shape of sperms is also called teratozoospermia. 

If it is associated with low motility and poor quality, the problem is severe. In other words, the semen analysis report should be looked at in-toto like how much is the volume, how much is the count per ML and how much is the count per ejaculate, then what is the motility. In that motility what is the percentage of active motility and passive motility and how many of them are completely non-motile and how many dead forms are present in the non-motile forms. In the morphology, whether the sperm quality is very poor or only some of them are abnormal. The combination of all these factors is important in a report. Just looking at one factor does not mean anything.

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