Understanding the Semen Analysis Test: Evaluating Male Fertility and Treatment Options

A semen analysis test is a medical procedure that evaluates different aspects of a man’s semen and sperm. The purpose is to check if the sperm count, shape, and movement are normal. The test can identify potential fertility problems in the male partner.

However, the semen analysis only provides one part of the complex fertility picture. A couple’s ability to conceive also depends on factors like the woman’s health, her genetics, lifestyle choices, and age. Nevertheless, comprehensive testing and analysis of the man’s semen gives couples struggling with infertility useful information to better understand their situation on the male side. This test assists them in making personalized decisions about options for starting a family.

Stay tuned and learn more about the test in this article!

Semen Analysis Test

Why Doctors Can Prescribe Semen Analysis

A doctor can recommend performing this test if a couple has failed to conceive after trying for 6 to 12 months, particularly if the woman is over 35 years old. Testing the man’s semen can identify any sperm abnormalities early on and help guide fertility treatments if needed. It may also be recommended to investigate potential causes of infertility if a patient has risk factors that could impact sperm production, or to confirm the success of a vasectomy procedure. Overall, semen testing is a standard step in fertility evaluation that provides valuable information to diagnose and address issues.

How to Get Ready for Semen Analysis?

  • Schedule the test with your doctor or a fertility clinic when you want to have your sperm count test.
  • Abstain from sexual activity for 2-5 days before collecting the sample and any activity that leads to ejaculation. This allows sperm counts to build up to reflect accurate numbers.
  • Keep the collection container at body temperature before producing the sample. The clinic or lab should provide a sterile specimen cup for collecting semen. Make sure it stays warm; putting it in an inside pocket for an hour before the test ensures a proper temperature. Cold temperatures can impact the motility of sperm.
  • Make sure to collect the entire semen sample for examination. This gives the most complete data about your sperm count and semen quality. Discarding any portion may exclude important information.
  • Record the time of ejaculation and abstinence periods. This provides essential data to interpret your results accurately.
  • Deliver the sample immediately after collection. Get the specimen to the clinic promptly, within 1 hour, to prevent inaccurate results. Keep at body temperature during transport.

How Semen Analysis Is Performed

Sample Collection

When ready to provide the sample, the man masturbates and ejaculates into a clean, wide-mouthed cup or container. It is best to collect the sample at the clinic or lab. That way, the sample does not risk becoming too warm or cold during transport, which could affect the sperm’s ability to swim.

Initial Macroscopic Examination

The fresh, untreated semen sample is first checked for:

  • Viscosity – how thick or thin it is;
  • Volume – amount ejaculated;
  • pH – acidity or alkalinity;
  • Liquefaction – how long it takes to liquefy;
  • Color – normal is grayish-white;
  • Presence of debris or blood.

Motility of Sperm

Using a microscope, the technician carefully analyzes the semen sample to determine what percentage of the sperm appear to be moving/swimming. The technician also closely evaluates the quality and vigor of the movement displayed by the sperm. Healthy, strong mobility is an important factor in the sperm’s ability to reach and fertilize the egg.

Sperm Concentration

A small amount of the semen sample is put onto a special microscopic slide called a counting chamber in order to measure the number of sperm per milliliter of fluid. Looking at the sperm per unit volume gives information about a man’s fertility, so getting an accurate measurement of sperm concentration is important.

Sperm Morphology

The technician creates a stained smear from the semen sample and analyzes it under the microscope. The focus is on evaluating the size and shape of the sperm. In ideal samples meant for conception, at least 4% of sperm will have normal morphological forms. Abnormal shapes and sizes can mean defects that impede the sperm’s motility and navigation abilities.

White Blood Cell Count

A high level of white blood cells detected in the semen could signify an infection. Infection can often negatively impact fertility.

Other Tests

The laboratory also cultures samples of the semen to test for infections that could be present. Antisperm antibody tests check for antibodies that attack sperm.

What Are Normal Results?

The lab report details all test results along with reference values. Your doctor interprets the results.

Semen Analysis Test Normal Report

It is considered that a normal semen analysis should show such parameters as:

  • Shape: Healthy sperm have an oval head and long tail, which helps them move. Over 85% of sperm should have a normal shape. Abnormally shaped sperm may have two heads, two tails, a crooked tail, or a large head.
  • Movement: At least 50% of sperm should have good forward movement. This helps them reach and fertilize the egg. Poor movement can prevent conception.
  • pH: Semen is alkaline, with a normal pH between 7.2 and 8.0. An abnormal pH can indicate infection or blockage.
  • Volume: The normal semen volume per ejaculate is 1.5-5 milliliters (mL). Low volumes below 1.5 mL can indicate low sperm production or blockages.
  • Liquefaction: Semen starts out gelatinous and liquefies over 15-30 minutes after ejaculation. Delayed or failed liquefaction can impact sperm health.
  • Sperm count: A normal sperm concentration is 15 million sperm per milliliter (mL) or more. Counts between 15-100 million per mL are optimal for fertility. Counts under 15 million (oligospermia) or a lack of sperm (azoospermia) can cause infertility.

Abnormal results on any parameter may require treatment or lifestyle changes.

Healthy Sperm vs Unhealthy Sperm Color

Normal semen color is whitish-gray. Yellow, green, or red semen may reflect infections, blood in the ejaculate, or other abnormalities.

Total Sperm Count Normal Range

The World Health Organization defines a normal total sperm count as 39 million per ejaculate or more. Counts between 39-300 million are considered normal. A low sperm count is called oligospermia.


While a single test does not define absolute fertility prospects, this simple, low-cost analysis of sperm count, shape, and movement delivers vital information to identify obstacles and guide next steps. Abnormal semen results enable understanding of deficiencies and personalized weighing of medical or assisted reproduction options to optimize chances of pregnancy. Though male fertility is complex, semen testing illuminates one critical piece of the intricate fertility puzzle. For couples struggling with infertility, a comprehensive male fertility test equips them to better comprehend their situation and thoughtfully create a family