The semen analysis is the gold standard for the male evaluation. This test can tell if sperm are present, how many and if they are moving. The semen analysis is important even if the male partner has previously fathered children. It can change during the reproductive years, but unlike eggs, sperm do not have a limited supply and new sperm are constantly being generated.

If a semen analysis is abnormal, it should be repeated to confirm since values can frequently fluctuate. However, persistent abnormalities may require further consultation with a male fertility specialist (urologist).

For the semen analysis, it is recommended to have 2-3 days of abstinence, but not more than 10 days. Longer or shorter periods of abstinence may actually decrease a sperm count or motility. Men should also avoid hot tubs or saunas for at least 3 weeks prior to the test. I have seen totally normal sperm counts temporarily go to zero after using a hot tub because the heat destroyed the sperm.

There is also a misperception that men should “store up” their sperm prior to their partner’s ovulation by abstaining from intercourse. Long periods of sexual inactivity actually results in more dead sperm and a decrease in their motility. For natural pregnancy attempts, intercourse every other day or every day is fine. There is no such thing as storing up sperm. Data shows that the highest chance of pregnancy is having intercourse before ovulation. Therefore, having frequent intercourse will help ensure that sperm will be ready and waiting in the fallopian tubes at the time of ovulation. In general, timed intercourse every day or every other day starting at least 6 days prior to ovulation is encouraged.

Often male patients ask me if there is anything they can take to improve their sperm quality. Some vitamin supplements may help although the data is inconclusive. Over-the-counter antioxidant supplements, such as Vitamin C (1000 mg per day) and Vitamin E (400 IU per day) may help with sperm quality.

You should talk to your provider regarding any medications that you are taking, including over-the-counter medications and supplements. For example, testosterone and steroids are especially detrimental to sperm production. Smoking and heavy alcohol use may also negatively impact sperm quality.