If you and your partner are trying to conceive and facing challenges, your doctor may recommend a semen analysis—the cornerstone of male fertility testing. This noninvasive lab test evaluates the quantity and quality of sperm in your semen and plays a vital role in identifying the cause of infertility.
This guide walks you through the semen analysis process, explains what each result means, and helps you understand what comes next based on your test outcome.
🧪 What Is a Semen Analysis?
A semen analysis measures several key parameters of semen and sperm health, including:
- Sperm count (concentration)
- Sperm motility (movement)
- Sperm morphology (shape)
- Volume of ejaculate
- pH and viscosity
- Presence of white blood cells, debris, or antisperm antibodies
It’s the most commonly ordered test when evaluating male infertility, as it provides a snapshot of reproductive potential.
📋 Why It’s Done
Semen analysis is typically performed for:
- Difficulty conceiving (after 6–12 months of unprotected intercourse)
- Pre-vasectomy evaluation
- Post-vasectomy follow-up (to confirm the absence of sperm)
- Assessment after vasectomy reversal
- Monitoring of fertility treatments
- Sperm cryopreservation (prior to cancer therapy, surgery, or travel)
🔬 How the Semen Analysis Process Works
1. Sample Collection
You will be asked to provide a semen sample, typically by masturbation into a sterile container. This is usually done:
- In a private room at a fertility clinic or lab
- Or at home (delivered to the lab within 30–60 minutes, kept at body temperature)
Instructions:
- Abstain from ejaculation for 2–5 days before the test
- Avoid alcohol, hot tubs, or fever within a few days prior
- Wash hands and genitals before collecting to avoid contamination
- Use only the provided sterile container; do not use lubricants unless approved
2. Semen Sample Handling
- The sample is examined within one hour of collection
- A computer-assisted semen analysis (CASA) or manual microscope evaluation is used
- If results are abnormal, a repeat test is usually ordered after 2–3 weeks to confirm
📊 Semen Analysis Results: What They Mean
Here’s how results are typically interpreted, based on WHO (World Health Organization) guidelines:
| Parameter | Normal Range | What It Indicates |
|---|---|---|
| Volume | ≥ 1.5 mL | Low volume may indicate blockage or ejaculatory issues |
| Sperm Concentration | ≥ 15 million/mL | Low count is called oligospermia; no sperm is azoospermia |
| Motility (progressive + non-progressive) | ≥ 40% | Poor motility (asthenozoospermia) may hinder fertilization |
| Progressive Motility | ≥ 32% | Indicates sperm’s ability to swim toward the egg |
| Morphology | ≥ 4% normal forms (Kruger criteria) | Poor morphology (teratozoospermia) may reduce fertility |
| Vitality | ≥ 58% live sperm | Assessed if motility is poor |
| pH Level | 7.2–8.0 | Lower or higher pH may signal infection or obstruction |
| White Blood Cells | < 1 million/mL | Elevated levels may suggest infection or inflammation |
⚠️ Common Abnormal Results and What They Might Mean
- Low sperm count → testicular dysfunction, hormonal imbalance, varicocele
- No sperm (azoospermia) → possible blockage or testicular failure
- Low motility → heat exposure, toxin exposure, lifestyle factors
- Poor morphology → genetic issues, oxidative stress
- High white blood cells → infection or inflammation (leukocytospermia)
🧬 What Happens After Abnormal Results?
If your semen analysis shows abnormalities, your doctor may recommend:
- Repeat semen analysis after lifestyle changes or time
- Hormone testing (testosterone, FSH, LH, prolactin)
- Scrotal ultrasound (to assess varicocele or obstruction)
- Genetic testing (especially for azoospermia)
- Sperm DNA fragmentation testing
- Referral to a fertility urologist
Sometimes, assisted reproductive technologies (ART) like IUI, IVF, or ICSI are used depending on the severity of the sperm abnormalities.
✅ How to Improve Semen Analysis Results
- Quit smoking, alcohol, and drugs
- Lose excess weight and exercise regularly
- Avoid heat exposure (hot tubs, saunas, laptops on lap)
- Eat a Mediterranean-style diet rich in antioxidants
- Take fertility supplements (under medical guidance)
- Manage chronic health conditions (diabetes, thyroid issues, infections)
It takes about 74 days to produce new sperm, so any improvement may take 2–3 months to show up in follow-up testing.
🧠 Key Takeaways
- A semen analysis is the first step in diagnosing male infertility.
- It evaluates sperm count, motility, morphology, and more.
- One abnormal result doesn’t always mean infertility—repeat testing is essential.
- Based on results, lifestyle changes, medications, or ART may be recommended.
- Early testing saves time and increases chances of success when trying to conceive.
📅 When to See a Fertility Specialist
If your semen analysis shows abnormalities, or you and your partner haven’t conceived after 6–12 months of regular unprotected sex, schedule an evaluation with a male fertility specialist or reproductive urologist.
