Thinking about having kids, whether it's next month or next year? Exciting, terrifying and overwhelming all at the same time! Let’s chat about how supporting healthy sperm development can get things off on the right foot.

First of all, being proactive about reproductive health is a smart move. You might be surprised to learn that around 30-40% of infertility cases are due to those whose sex was recorded male at birth fertility issues. So, taking steps now can make a big difference later on.

What Causes Male Infertility?

There are a few main causes of those whose sex was recorded male at birth infertility, which generally fall into three categories:

1. Sperm Production Disorders The brain sends signals to the testicles to produce sperm using hormones like follicle-stimulating hormone (FSH) and luteinising hormone (LH). Sometimes, even if the signals are there, the testicles might not be able to produce sperm, or the signals might not be strong enough. Depending on the issue, doctors can often use medications to balance hormones or even retrieve sperm directly from the testicles.
2. Obstructive Issues These issues happen when something blocks the sperm from being ejaculated, leading to a reduced sperm count. This can be congenital, like being born without a vas deferens, or it could result from a failed vasectomy reversal. Some AMAB folks, especially those with diabetes, might experience retrograde ejaculation, where semen flows into the bladder instead of out of the urethra. Fertility specialists can often extract sperm from the epididymis (a tube at the back of the testicles) or, in the case of retrograde ejaculation, from the urine after reducing its acidity with medication.
3. Immune System Dysfunction Sometimes, the immune system can mistakenly attack the sperm, making it harder for them to move. If this happens, doctors can “wash” the sperm to remove the antibodies and then use advanced reproductive techniques like IVF to help with conception.

What’s a Semen Analysis? When Should It be Done?

A semen analysis is a simple, non-invasive test examining sperm count, motility, and morphology (more on these shortly). It’s a great first step in a fertility work-up because it can reveal a lot about sperm's health. If you’re using a sperm donor, are in a same-sex couple or you and your partner have been trying to conceive for a year (or six months if she’s over 35) without success, it’s a good idea to get this test done. If you suspect any issues due to past testicular trauma, erectile dysfunction, or ejaculation problems, don’t wait—get tested sooner. 

How exactly is sperm collected?

This test can be performed either at home using a semen analysis kit or in a clinical lab. Here's a breakdown of how the process works:

At Home: If using an at-home kit, you, your partner or your donor will be asked to collect your semen sample in a sterile container, usually through masturbation. It’s important to follow specific instructions, like abstaining from ejaculation for 2-5 days before the test. The sample needs to be delivered to the lab or tested immediately (within 30-60 minutes), as sperm health declines quickly after ejaculation. Some kits come with shipping containers designed to preserve the sample during transport.

In the Lab: In a clinic or lab setting, you, your partner or your donor will provide a sample in a private room, often via masturbation into a sterile container. In some cases, condoms specifically designed for semen collection can be used during intercourse; to flag, regular condoms should not be used due to spermicide. The sample is then analysed immediately or stored under optimal conditions.

In both circumstances, it’s crucial that the entire ejaculate is collected in the container because different portions of the semen can have different sperm concentrations. Often, at least two semen analyses, conducted several weeks apart, are recommended for accurate assessment as there are so many factors, even down to the underwear worn, that can impact semen analysis. 

So, what are the signs of healthy sperm?

1. Sperm Count - The total number of sperm in a single ejaculation. Typically, a healthy sperm count is considered to be at least 15 million sperm per millilitre of semen. A higher sperm count increases the chances of one sperm successfully fertilising an egg.
2. Motility - The ability of sperm to move efficiently through the female reproductive tract. At least 40% of sperm should exhibit forward progression or be classified as motile. Sperm must be motile to swim through the cervix, uterus, and fallopian tubes to reach and fertilise the egg.
3. Morphology - The shape and structure of sperm. A healthy sperm sample typically has at least 4% of sperm with normal morphology (that’s, an oval head and a long tail). Proper morphology is vital because abnormal shapes can impair the sperm's ability to penetrate and fertilise the egg.
4. Vitality - The percentage of live sperm in a semen sample. Ideally, at least 58% of the sperm should be alive . Sperm vitality is crucial as dead or immotile sperm cannot fertilise an egg.
5. Semen Volume - The total amount of semen ejaculated. Normal semen volume ranges from 1.5 to 5 millilitres per ejaculation. Adequate semen volume is necessary to transport sperm through the reproductive tract.

Knowing more about sperm health can give you the power to make informed decisions and take the right steps toward having children. And, of course, taking a supplement for sperm and using fertility-friendly lubricants can also support your efforts.

Key Takeaways for those all important Swimmers

• Proactive Health: those whose sex was recorded male at birth fertility issues cause 30% of infertility cases, so taking early action is crucial.
• Infertility Causes: Includes sperm production disorders, obstructive issues, and immune system dysfunction.
• Semen Analysis: A key test for sperm health, recommended after a year of trying to conceive or earlier if issues are suspected.
• Next Steps: Understanding sperm health helps in making informed decisions; supplements and fertility-friendly lubricants can help.