The Andrology wing of a fertility center tends to be shrouded in mystery… what exactly goes on behind those closed doors? What are they testing? How does “Andrology” fit into my family building puzzle? As single men or gay male couples, the topic of fertility (or infertility) is probably low on your list of questions, as you consider the many pieces of your egg donation, IVF, and surrogacy journey.
If you’re a mom to be, whether you’re single or in a same-sex relationship, this area of the fertility clinic can be equally befuddling. Whether you’re using a known sperm donor or a sample from a sperm bank, understanding this variable in your family building is an important step. Knowledge is power, and you should feel empowered to know which questions to ask, and where to get your answers.
In my role here with Gay Parents To Be, I speak to many prospective parents who have already begun their family building journeys. Once everyone begins to understand the process, the semen analysis and report is one thing that almost everyone has questions about. What are they testing? Why are they testing?
Andrology focuses on the male reproductive system. In the words of medical director Mark Leondires, in the fertility journey metaphor, “the sperm is the car key, that gets everything started”. It’s just one piece of the puzzle, but a crucial one, so it’s important to make sure everything is working properly and effectively. Fortunately, we have a great team and resources at our fingertips here, working in collaboration with the RMA of Connecticut laboratory. We reached out to the team lead of the Andrology Lab to get the dish on some of your frequently asked questions.
For Dads To Be (or anyone wondering about their upcoming semen analysis)
What can I expect for my semen analysis appointment when I arrive to Gay Parents To Be?
“At Gay Parents To Be, we work in partnership with RMA of Connecticut, so you have full access to the accreddited lab and laboratory staff here. It is important that we provide a professional, comfortable, and smooth experience for all our patients. When arriving to your appointment, our front desk will check you in and guide you through any necessary paperwork. One of our andrologists will then take you to our laboratory which is private and isolated from the rest of the patient area. The laboratory wing of our practice has individual patient rooms where we will provide you with all the necessary materials to collect your sample. This provides our patients with the privacy they need, while also making it convenient to pass their sample directly to a lab staff member upon completion.”
I don't think I produced a large enough sample - is this enough?
“Yes. We can do a lot with a low volume sample. On average less than 50 microliters is needed to perform all the tests in a semen analysis. Having a low volume may affect other procedures such as IUI or cryopreservation. In those instances, a lab technician will make you aware of any additional steps.”
What happens to my sample once you’re done analyzing it?
“Once we are done testing a sample, it is discarded into biomedical waste bin. This ensures that your sample does not remain in the lab unless otherwise consented (storage of cryopreservation specimens). Discarded specimens are disposed of according to protocol ensuring that there is no risk being transferred.”
I’m a bit anxious. Can my partner come in the room with me?
“Absolutely! We just ask that there is no oral sex because saliva does affect the viability of the sperm. If you do wish to have intercourse, please ask for a collection condom from one of our lab technicians.”
Why do I need 2-5 days of abstinence prior to my appointment?
“Your body is continuously generating sperm. Nevertheless, your body also needs time to keep up with demand. Having an abstinence period of less than two days may affect the sperm sample. Coincidently, allowing too much time to pass can also provide undesirable results. Staying within the 2-5 day window will provide the best outcome for your appointment. We ask that you be mindful of this prior to your scheduled appointment.”
I am unable to produce my specimen at the office. Can I produce at home?
Yes. If you need to produce at home, please be sure to pick up a collection kit from any of our offices. It will provide everything you need to properly collect your sample.
Please make sure to bring the sample within 45 minutes from the time of collection to ensure the most accurate results.
How do you know my sample won’t be confused with someone else's?
“RMA of CT has a very strict and well thought out protocol specifically to avoid any mix up of specimens. We will have you review and initial 15 labels that we will use for your specimen and paperwork. Your specimen cup will be labeled twice, and it will be sealed by you. All specimens are logged into a book where we record several identifying factors. We also provide a unique accession number specifically to your sample while performing any procedure. We have a very extensive protocol and if you have any concerns please reach out to any lab staff member. It is important that you are comfortable during your time with us.”
Results, Cost, and More
What are some of the tests you will be performing on the sample?
“There are many different procedures we perform in the andrology laboratory. Common with all procedures is gathering a sperm concentration, motility, and Total Motile Sperm (TMS). Your concentration is the number of sperm per milliliter of ejaculate. This is important in making certain decisions in your fertility journey. Motility correlates to the percentage of the sperm that is moving in the sample. These two numbers affect what we call “TMS” or “Total Motile Sperm.” This number is particularly important for procedures such as IUI (intrauterine insemination) because it tells us the total number of moving sperm in the entire ejaculate. This is just an example of a small part of what we do here at the Gay Parents To Be/RMA of Connecticut andrology lab. If you have any questions, we encourage you to ask a lab staff member.”
How long will it take to receive semen analysis results?
Individuals/couples who are registered as Gay Parensts To Be/RMA of Connecticut patients should receive a call from their nurse or doctor within 5-7 business days. Outside patients who are referred to us by their physician should expect their results within 7-10 business days. Reports are reviewed by the lab staff and then faxed to your referring physician once signed off.
What do all the numbers in those results mean?
You will be given information about the concentration. This tells us how much sperm is in one milliliter of ejaculate. We then would discuss what percentage of the sperm is moving; this is described as motility. We use these two values in conjunction with the sample’s volume to calculate TMS or “total motile sperm.” This tells us how many moving sperm is in the entire ejaculate sample. This is important for certain decisions made in the laboratory.
Another important test is morphology. Morphology looks at the shape of the sperm as well as identifying key structures and ensuring they are normal. Similar to the other tests we perform, morphology is an important factor in many procedures; especially in the embryology laboratory.
Interpreting these results can be challenging. If you have any concerns or questions we highly recommend reaching out to myself, a nurse, or your doctor.
How much does a Semen Analysis cost?
The cost of a semen analysis depends on your insurance coverage. If your insurance does not cover any part of the analysis, we charge $160.
Is there a lab staff member I can talk to if I have questions?
Yes! Feel free to speak with any of our andrologists. Or, feel free to call me, Kyle Tzanetis (Team Lead of the Andrology Lab) at (203) 290-6522.
Finding out your fertility potential is step one in the entire family-building process. But in order to feel confident and not lost in the weeds of all the medical jargon, it’s important to know what’s happening with testing and treatment. Through these FAQs and utilizing Kyle as your patient liaison, andrology is hopefully a better understood resource to reach your family goals.