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Advise on following SEMEN ANALYSIS report, ways to improve.

Resolved Question:

Dear Doctor,

I just got my semen analysis report and it states the following:

Physical Examination
Duration of Abstinence: 2 days
Liquefaction at 37° C: 40.00 minutes
Volume: 2.00 mL
Appearance: Viscid opaque
Colour: Whitish
Viscosity: Thick
pH: 7.5

Microscopic Examination
Total Sperm Concentration 8.00 million/mL
Percentage Motility 40.00 %
Grade A (Progressive motile) 5.00 %
Grade B (Non progressive motile) 35.00 %
Grade C (Immotile) 60.00 %
Agglutination Negative
Pus Cells 5-7 /hpf
Red Blood Cells Nil /hpf
Epithelial Cells Nil /hpf

Normal Morphology 50.00 %
Abnormal Morphology 50.00 %
(a) Head Defects 30.00 %
(b) Neck & Midpiece 10.00 %
(c) Tail Defects 10.00 %

Chemical Examination
Semen Fructose Qualitative Positive Positive

Please advise about these results and how I can improve these.

Thanking you for your support.

Category: Infertility Specialist

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Category: Infertility Specialist
 22 Doctors Online

Thanks for your query at
Please let me know a few more details.
What is your age?
Why did you get the semen analysis done?
Also, can you upload the report as received directly from the lab, instead of typing out the values manually?
Different labs use different standards for the semen analysis, hence I want to have a look at the actual report.
Looking forward to hearing from you.
Take care.

Patient replied :

Dear Doctor,
As requested, attached is the report. I attached the report earlier as well, not sure why it didn’t reach you.
I am going to turn 41 in few months. The reason for semen analysis arose after my wife had a miscarriage around 5th month into pregnancy and after reading about that, I realized that it could be possibly due to some damage to sperms as well, though no doctor that we consulted prescribed the test.
A test done around 2.5 months ago showed sperm concentration as 2mill/ml and pH as 8.2.
I am a smoker and a regular drinker but for last month or so I have stopped having whiskey or any other hard alcohol and in place having around 3 glasses of red wine every evening and have cut down cigarettes by over half. Besides these I have been more physically active so I wish to understand if these changes have helped increase the sperm count.
These days I smoke around 6-10 cigarettes a day as against over 20 around a month back.
More about recent medial history:
Regarding medical history, the only thing that I can think of being life threatening is that I suffered from Pulmonary Tuberculosis in 2010 and took treatment for the same for 9 months.
Post that no other serious illness but I guess those medicines affected my liver a bit as enzymes levels (GGT, AST/SGOT, AST/SGPT, etc.) gets disturbed at time.
I usually take Ursicol 300 for liver and also since my last report showed high LDL and not a good ratio of LDL/HDL so have been taking Resouvas 20 once daily for last few weeks.
Sometimes, I also take other supplements like Cozim-Q (Co Enzyme Q) and Carvic(assortment of essential fatty acids and l'arginine) and Vitamin B complex suppliments like Neurobion Forte and took Benalgis for some time for pre-diabetic condition. For antioxidants, I drink green tea and some times drink ProArgi-9+ apart from some antioxidants that I get from foods and red-wine.
Please let me know if you need more information from my end.
Thanks and regards

Hi again.
Thank you for the detailed update.
The semen count is very low and the motility is not optimal too.
The reasons are very possibly as follows - Alcohol and cigarette smoke.
Even though you have cut down, the two are still culpable, particularly the number of cigarettes is way too high.
Common reasons for such a semen count can include - smoking, drinking, late nights, being overweight, chromosomal syndromes, hormonal deficiencies, infections, blockages etc.
IN your case, smoking and drinking stand out as obvious reasons.
Also, what is your height and weight ?
Apart from taking the supplements, you need to quit alcohol and tobacco - it is paramount.
Also, please consult an Andrologist, and go for a complete evaluation to rule out other co existent causes.
With this report, for the time being, fertility will be made possible by assisted reproduction - IVF / ICSI.
All the best.
Please feel free to discuss further.

Patient replied :

Dear Doctor,
Thanks for your reply.
My height is 182 cms and weight 77kgs. Also, as I can see from your response, I have been working late nights for many years old patientand that could also be one of the contributing reasons.
Please help me undertand the point that I raised in my initial email i.e.
"I am a smoker and a regular drinker but for last month or so I have stopped having whiskey or any other hard alcohol and in place having around 3 glasses of red wine every evening and have cut down cigarettes by over half. Besides these I have been more physically active so I wish to understand if these changes have helped increase the sperm count."
Is the increase in sperm count due to reduction in alcohol and cigarettes?
I have read that red wine taken in moderation is good for heath due to antioxidants and vitamins present in it. Isn't talkng around 3 glasses (around 375ml) of red wine safe?
Also can taking suppliment like Speman (from Himalaya) will help.
Best regards

HI again.
Yes, cutting back on the alcohol and cigarettes would have increased the count.
Around 5 ounces per day of red wine is supposed to be beneficial, but there are various fruits and vegetables that provide the same antioxidant levels, you can actually stop drinking wine.
And the number of cigarettes even after cutting down are high.
Speman or supplements will not work until these factors are worked at.
Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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