Q: I am a 35 years old male. My semen analysis report states sperm head agglutination and that fructose is positive. What does this mean?

A:Fructose in semen originates from seminal vesicles. Fructose testing has a meaning only in patients with azoospermia (no sperms seen) and especially in those whose ejaculate volume is less than 1 ml, suggesting seminal vesicle obstruction or its absence by birth. Absence of fructose, low semen volume, and failure of the semen to coagulate indicate either congenital absence of the vas deferens and seminal vesicles or obstruction of the ejaculatory duct. Sperm agglutination in semen can be caused by various inflammatory conditions, like prostatitis, and is commonly seen with the presence of antisperm antibodies (substances that cause the sperm to stick together). In presence of prostatitis, the finding will be present along with plenty of white blood cells in the semen. This can have an adverse effect on fertility. Semen findings individually may not mean much and, thus, have to be correlated with clinical condition and other associations. Please see your treating physician for proper interpretation.