A foundational step in male fertility evaluation
What Is a Semen Analysis?
A semen analysis is the primary diagnostic tool used to assess male fertility. It evaluates multiple factors related to sperm quality and function, offering insight into a man’s ability to conceive naturally or with assistance.
Key Parameters Measured
Liquefaction
Semen should liquefy within 15–60 minutes of ejaculation, with 15 minutes being ideal. Delayed liquefaction may interfere with sperm motility.
Appearance
Normal semen is grayish and opalescent.
- Yellowish tint may indicate high vitamin intake, extended abstinence, or jaundice.
- Red or pink tint may suggest infection or the presence of blood.
Volume
Typical semen volume ranges from 1 to 5 mL.
- Low volume may signal retrograde ejaculation, obstruction, or issues with the seminal vesicles or prostate.
- High volume may dilute sperm concentration.
Agglutination
This refers to sperm sticking together. High levels may indicate anti-sperm antibodies, often following reproductive tract surgery. These can impair motility and prevent sperm from penetrating cervical mucus.
Motility
This measures the percentage of sperm that are actively swimming.
- Progressive motility is essential for conception.
- At least 32% should be progressively motile.
- Community labs may not distinguish between twitching and forward-moving sperm — fertility clinics are preferred for accurate results.
Concentration
Refers to the number of sperm per mL of semen.
- Normal: ≥15 million/mL
- Affected by diet, lifestyle, and underlying health conditions.
- Extremely low concentration may suggest genetic or chromosomal issues.
Total Sperm Count
This is calculated by multiplying the concentration by the total volume.
- Normal: ≥39 million sperm per ejaculate
Morphology (Shape)
A minimum of 4% normal forms is considered acceptable. Abnormal morphology can impair fertilization even if count and motility are normal. Toxin exposure plays a key role here.
Acidity (pH)
Normal semen pH is between 7.2 and 8.0.
Round Cells
These may be immature sperm or white blood cells. Elevated levels may indicate infection or inflammation.
WHO Reference Values (2010)
- Volume: >1.5 mL
- Concentration: >15 million/mL
- Motility: >40% total, with ≥32% progressive
- Morphology: >4% normal forms
Collection Guidelines
- Abstain from ejaculation for 2–4 days before sample collection.
- Collect via masturbation into a sterile container — either at the clinic or at home (returned within 1 hour and kept at body temperature).
- Do not use standard condoms — only special sperm-safe collection condoms if required.
- Interrupted intercourse is not recommended as it risks incomplete collection.
Important Notes
- Timing matters — semen must be analyzed within 60 minutes of ejaculation. Many community labs fail to meet this standard, affecting results.
- Always consider getting at least two analyses, spaced 2–3 months apart.
- Recent illness, fever, medications, alcohol, tobacco, drugs, or heat exposure (like hot tubs) within the last 100 days can affect sperm — be sure to disclose this to your practitioner.
Additional Testing (When Necessary)
If initial results are abnormal or if fertility remains unexplained, additional tests may include:
- Anti-sperm antibody testing (if clumping, high white blood cells, or viscosity is observed)
- Post-ejaculate urinalysis (to detect retrograde ejaculation)
- Hormonal tests: Testosterone, FSH, LH, Prolactin, Estrogen, Cortisol, Thyroid Panel, DHEA, Glucose/Insulin
- Genetic testing: Karyotyping, Y-microdeletions, or screening for Klinefelter’s syndrome
Fertility Lab vs. General Lab
Whenever possible, have your semen analysis performed at a fertility-specific lab. They follow precise protocols for sample handling and timing — leading to far more reliable results. A small investment here can prevent misdiagnosis or delayed treatment.
Understanding the Terminology
- Normozoospermia – All parameters are within the normal range
- Oligozoospermia – Low sperm concentration (<15 million/mL)
- Azoospermia – No sperm in ejaculate
- Aspermia – No ejaculate
- Asthenozoospermia – Poor motility
- Teratozoospermia – Poor morphology
Age-Related Decline
- Semen volume drops by approximately 20% between ages 30 and 50
- Sperm count declines about 5% per year
- Motility decreases by approximately 3% annually
Final Thoughts
A semen analysis is a vital step in understanding male fertility potential. However, it is only part of a complete evaluation. Speak with a qualified reproductive specialist to ensure accurate interpretation and to explore appropriate next steps.
If you are unsure where to begin, our clinic offers comprehensive male fertility evaluations, semen testing referrals, and integrative treatment plans tailored to your needs.
