Q: I am a 28-year-old male, and I feel that for the last 18 months my ejaculation volume has reduced to less than 2 ml. I will get married in six months, so this problem is bothering me a lot. I have consulted a urologist regarding this problem. He conducted a semen culture test and not a semen analysis test since I am unmarried. The result shows that I have an infection in my sperm. I took the medicine given by the doctor, but still feel my ejaculation volume is less. I ejaculate once in 2 (or) 3 days. What is my problem? The doctor is not ready to do a semen analysis test and he has asked me to get married first. He also said that I need not worry too much, as stress can affect my sexual life after marriage. I don't have any pain in my penis. What are the factors that affect seminal volume? I smoke 3-4 cigarettes per day.

A:The WHO guidelines define pH, volume, concentration, total sperm count, total motility, grade A motility, viability and morphology criteria for a normal semen. Large studies monitoring semen parameters of men partnering pregnant females, however, reveal the WHO criteria to be too stringent. Only 60-75 per cent fertile men meet each single criterion, and none meet all the criteria laid down. Semen parameters in a single man clearly can be variable. Abstinence and ejaculatory frequency are most important factors affecting them, including the volume. I hope that you now realise that volume of the semen, which has bothered you so much, is just one of many facets of semen analysis, and the criterion of more than 2 ml is met only by two-thirds of fertile men. All men, married or unmarried, may have the semen analysis done. Smoking is one factor significantly associated with reduced seminal volume.