What Is Semen Analysis?
Semen analysis, also known as a sperm count test, analyzes
the health and viability of a man’s sperm. Semen is the fluid containing sperm (plus other sugar and
protein substances) that’s released during male ejaculation. A semen analysis
measures three major factors of sperm health:
- the number of sperm
- the shape of the sperm
- the movement of the sperm, also known as “sperm motility”
Doctors will often conduct two or three separate sperm
analyses to get a good idea of sperm’s health. According to the American
Association for Clinical Chemistry (AACC), the tests should be conducted at
least seven days apart and over the course of two to three months. Sperm counts
can vary on a daily basis. Taking an average of the sperm samples can give the
most conclusive result.
Why Undergo Semen Analysis?
A semen analysis is often recommended when couples are having
problems getting pregnant. The test will help a doctor determine if a man is
infertile. The analysis will also help determine if low sperm count or sperm
dysfunction is the reason behind infertility.
Men who have had a vasectomy undergo semen analysis to make sure
no sperm are in their semen. In a vasectomy,
the tubes that send sperm from the testicles to the penis are cut and sealed as
a permanent form of birth control. After a vasectomy, doctors often recommend
that men take a sperm analysis once a month for three months to ensure that
sperm is no longer present in their semen.
How to Prepare for Semen Analysis
Your doctor will let you know what you should do in preparation
for the semen analysis. It’s very important to follow these instructions for
To get the best sample:
- avoid ejaculation for 24 to 72 hours before the
- avoid alcohol, caffeine, and drugs such as
cocaine and marijuana two to five days before the test
- stop taking any herbal medications, such as St.
John’s wort and echinacea, as instructed by your healthcare provider
- avoid any hormone medications as instructed by
your healthcare provider
Discuss any medications you’re taking with your doctor.
How Is Semen Analysis Conducted?
You’ll need to provide your doctor with a semen sample for a
semen analysis. There are four main ways to collect a semen sample:
- sex with a condom
- sex with withdrawal before ejaculation
- ejaculation stimulated by electricity
Masturbation is considered the preferred way to get a clean
Getting a Good Sample
Two main factors are crucial to having a good testing
sample. First, the semen must be kept at body temperature. If it gets too warm
or too cold, the results will be inaccurate. Second, the semen must be
delivered to the testing facility within 30 to 60 minutes of leaving the body.
Some factors can negatively affect the test, including:
- semen coming into contact with spermicide
- taking the test when you’re ill or stressed
- inexpert lab technician
- contamination of the sample
There are no known risks associated with a sperm analysis.
If semen analysis results aren’t within normal limits and
handling of the specimen isn’t a factor, your doctor may also consider you’re
taking the following substances, which can affect your sperm count:
- herbs, such as St. John’s wort
- prescription drug use of medicines known to
reduce sperm count, such as cimetidine
- recreational drug use
What Are Normal Results?
When a doctor reviews sperm analysis test results, there are
many factors to consider. An analysis after vasectomy looks for the presence of
sperm, but the analysis to look for fertility issues is much more in depth. Your
doctor will take each of the following results into account:
A normal result for
sperm shape is that more than 50 percent of sperm are normally shaped. If
a man has greater than 50 percent of sperm that are abnormally shaped, this
reduces his fertility. A laboratory may identify abnormalities in the sperm’s
head, midsection, or tail. It’s also possible the sperm could be immature and
therefore not able to effectively fertilize an egg.
For a normal result, more than 50 percent of sperm must move
normally an hour after ejaculation. Sperm movement, or motility, is important to
fertility because sperm must travel to fertilize an egg. An automated system
analyzes the sperm for movement and rates them on a scale of 0 to 4. A score of
0 means the sperm are not moving, and a score of 3 or 4 represents good
A pH level should be between 7.2 and 7.8 to achieve a normal
result. A pH level higher than 8.0 could indicate the donor has an infection. A
result less than 7.0 could indicate the specimen is contaminated or that the
man’s ejaculatory ducts are blocked.
The volume of sperm for a normal result should be greater
than 2 millimeters. A low sperm volume could indicate a low amount of sperm to
fertilize an egg. An excess fluid volume could also mean the amount of sperm
present is diluted.
It should take 15
to 30 minutes before semen liquefies. While semen is initially thick, its
ability to liquefy, or turn to a watery consistency, helps sperm to move. If
semen does not liquefy in 15 to 30 minutes, fertility could be affected.
The sperm count in a
normal semen analysis should be between 20 million to over 200 million. This
result is also known as sperm density. If this number is low, conceiving can be
The appearance should be whitish to gray and opalescent. Semen that
has a red-brown tint could indicate the presence of blood while a yellow tint could
indicate jaundice or be a medication side effect.
What Do Abnormal Results Mean?
Abnormal sperm will have trouble reaching and penetrating eggs, making
conception difficult. Abnormal results could indicate the following:
- hormonal imbalance
- disease, such as diabetes
- gene defects
- exposure to radiation
If your results come back at abnormal levels, your doctor will
probably suggest that you take additional tests. These tests include:
- genetic tests
- hormone testing
- urinalysis after ejaculation
- taking a tissue sample from your testicles
- anti-sperm immune cells testing
Outlook After a Semen Analysis
A semen analysis that’s the most conclusive requires careful
collection and analysis of multiple specimens. The test can provide a variety
of information that could help determine factors that affect your fertility. If
your test results are abnormal, your doctor may recommend that you see a