Semen Analysis Results Explained
A semen analysis is the first and most basic test used to assess male fertility. The report contains several parameters, and they need to be read together rather than one at a time.
This article explains what each heading on the report means, how the test is done, and why a single result is rarely the whole picture. For background see our guide to male infertility and IVF.
How is a semen analysis performed?
The sample is usually produced under laboratory conditions after 2 to 7 days of abstinence. It should be collected in a sterile container and reach the laboratory quickly.
The analysis follows the standard methods set out in the World Health Organization laboratory manual, which is what makes results from different laboratories comparable.
What is on the report?
A semen analysis report generally includes:
- Volume: the amount of semen in millilitres.
- Concentration: the number of sperm per millilitre.
- Total sperm number: volume multiplied by concentration.
- Motility: the proportion of moving sperm and the quality of that movement (progressive, non-progressive, immotile).
- Morphology: the proportion of normally shaped sperm.
- Vitality: the proportion of live sperm.
- Leukocytes: white cells, which may point to infection or inflammation.
What do the reference values mean?
The reference ranges are lower limits derived from large groups of men who had achieved a pregnancy. Falling below them does not mean infertility, and being above them does not guarantee a pregnancy.
They are a guide, not a pass or fail line, which is why the result is always interpreted alongside the couple's wider assessment.
Is one test enough?
No. Sperm parameters vary within the same person from week to week. A feverish illness, heavy stress, poor sleep, heat exposure or certain medicines can all lower a result temporarily.
For this reason a low result is usually repeated after an interval. Where two tests differ noticeably, the assessment takes that into account.
What happens if the result is low?
The first step is to repeat the test and arrange a fuller male assessment: examination, hormone tests and imaging where indicated. Correctable causes such as lifestyle factors and varicocele are looked for.
In some cases sperm DNA integrity is also assessed, see our article on sperm DNA fragmentation.
How results shape the treatment plan
The findings help determine which approach fits. Where parameters are adequate, IUI may be considered. Where male factor is pronounced, ICSI is used within IVF.
The decision is made together with the female partner's assessment and is individual. Results vary from person to person.
Related Reading
- Male Infertility and IVF: Causes, Diagnosis and Treatment Options
- ICSI (Micro-injection)
- Sperm DNA Fragmentation: What It Means for Fertility
Sources and references
This article is supported by the following independent, authoritative sources: