damage DNA damage in sperm cells that is related to infertility can be probed by analysis of DNA susceptibility to denaturation in response to heat or acid treatment and/or by detection of DNA fragmentation revealed by the presence of double-strand breaks detected by the TUNEL assay. Other techniques performed in order to measure the DNA fragmentation are: SCD (sperm chromatin dispersion test), ISNT (in situ nick translation), SCSA (sperm chromatin structural assay) and comet assay. Total motile spermatozoa Total motile spermatozoa (TMS) or total motile sperm count (TMSC) is a combination of sperm count, motility and volume, measuring how many million sperm cells in an entire ejaculate are motile. Use of approximately 20 million sperm of motility grade c or d in ICI, and 5 million ones in IUI may be an approximate recommendation. Others The sample may also be tested for white blood cells. A high level of white blood cells in semen is called and may indicate an infection. Cutoffs may vary, but an example cutoff is over 1 million white blood cells per milliliter of semen. Abnormalities Aspermia: absence of semen Azoospermia: absence of sperm Hypospermia: low semen volume Hyperspermia: high semen volume Oligozoospermia: Very low sperm count Asthenozoospermia: poor sperm motility Teratozoospermia: sperm carry more morphological defects than usual Necrozoospermia: all sperm in the ejaculate are dead Leucospermia: a high level of white blood cells in semen Factors that influence results Apart from the semen quality itself, there are various methodological factors that may influence the results, giving rise to inter-method variation. Compared to samples obtained from masturbation, semen samples from collection condoms have higher total sperm counts, sperm motility, and percentage of sperm with normal morphology . For this reason, they are believed to give more accurate results when used for semen analysis. If the results from a man's first sample are subfertile, they must be verified with at least two more analyses. At least two to four weeks must be allowed between each analysis. Results for a single man may have a large amount of natural variation over time, meaning a single sample may not be representative of a man's average semen characteristics. In addition, sperm physiologist Joanna Ellington believes that the stress of producing an ejaculate sample for examination, often in an unfamiliar setting and without any lubrication (most lubricants are somewhat harmful to sperm), may explain why men's first samples often show