What Can a Semen Analysis Tell About a Man’s Health?
This article is about the growing evidence that a man’s semen analysis results can warn of other serious health issues, known and unknown, that are a threat. This was written by Dr Sheldon H F Marks, instructor at international fertility and urology meetings and author of the only textbook on vas reversals,”Vasectomy Reversal: Manual of Vasovasostomy and Vasoepididymostomy.”
For several years, many studies have shown something that urologists instinctively understood but now we know to be a fact – that a man’s fertility tells us a lot about his general health. Research at Stanford University by Men’s Heath Expert Dr. Michael Eisenberg, (Male infertility as a window to health, Choy JT, Eisenberg ML. Fertil Steril. 2018 Oct;110(5):810-814), a top internationally known urologist specializing in male reproductive health, confirms that a man’s fertility, as we know with erectile function can be a barometer of his overall health and wellness. This is especially important as we look at the semen analysis after a vasectomy reversal.
Of course, the big question is whether his health issues are what may be hurting a man’s fertility or is the man’s DNA responsible for the fertility problem as well as the other medical issues such as inflammation after the reversal?
What does this mean?
Any man should consider any and all issues with fertility to be a possible red flag to see their doctor and get things checked out, and more than just a semen analysis. He should go see his primary care doctor for a comprehensive medical check-up – to include a complete physical exam, appropriate blood work, and hormone levels to check his thyroid, liver, blood sugar, heart and kidneys as well as his testosterone, estrogen and other hormone levels.
Doctors know that there are many health issues that can negatively impact on a man’s fertility. This means that if a man has fertility issues, then it’s makes sense to look for other possibly hidden health concerns. This is logical if a man has significant health problems such as diabetes, high blood pressure or other long-standing illnesses as these can impact on his fertility and so the ability to father children and pass on his DNA. This is why it is important to get all health issues under control before a vasectomy reversal.
Urologists know that one out of every 100 men who show up for evaluation of their infertility will be found to have a previously unknown testicular cancer (Infertility with Testicular Cancer. Ostrowski KA, Walsh TJ. Urol Clin North Am. 2015 Aug;42(3):409-20). This is why any man with fertility concerns must be seen by a urologist. Simply retrieving sperm as many doctors do for IVF without looking to understand why he has fertility issues can allow serious problems to progress with dangerous consequences.
Many times male factor issues can be successfully treated such as a varicocele, which is a collection of veins above the left testicle. If there is damage to the sperm then we think of oxidative damage which may be treatable with oral antioxidants and an increase in healthy, antioxidant rich foods. This then allows the couple to try conceiving naturally which provides the healthiest children without the added risks and expenses of assisted reproductive techniques.
It is unfortunate that many men with low sperm counts are often blindly pushed into the sperm donor path for IVF, ignoring the big question as to why he has low counts or motility. IVF, though very effective for most couples, is significantly more expensive and has the added risks to the mother and babies. It is a disservice to the man to ignore the fact that his fertility may be correctable so they can have a baby naturally. Plus, as described many male fertility issues may be a warning sign of something more insidious that needs to be addressed.
Key take home point– if there’s any question about fertility then it is wise to see a urologist. This way each patient can find out if it’s something that’s treatable and also to see if it really may be an early warning sign of a deeper health issues that may also be impacting on fertility.
If couples have any questions about what is written on this page, or about fertility or vasectomy reversals, we are available to talk or respond by email, Zoom, Skype or Face Time. We will respond and answer any questions!
This article was reviewed, updated and edited by Dr Sheldon Marks on July 13, 2023.
