A semen analysis is the main test of male fertility. A sample is examined under a microscope to measure its volume and the number, movement and shape of the sperm. It is quick, painless and usually done early, because sperm problems are a common part of a couple's difficulty conceiving.
What it is
A semen analysis is a laboratory look at a fresh semen sample. It shows how much semen there is and how many sperm it contains, how well they swim and what share are normally shaped.
- Volume: how much semen is produced.
- Concentration (count): how many sperm per millilitre.
- Motility: the percentage of sperm that are moving.
- Morphology: the percentage of sperm with a normal shape.
Who it's for
It is one of the first tests when a couple is having trouble conceiving, because the male partner's results shape the whole plan. Men who have had a vasectomy also use it to confirm the procedure worked.
- Couples having trouble conceiving: the male partner is tested early
- Men after a vasectomy, to confirm it has worked
- Couples planning IUI or IVF, to help choose the method
Male factors are common in couples who have trouble conceiving, so testing both partners at the start avoids delays.
Step by step
- AbstainDo not ejaculate for at least 48 hours, and no longer than 7 days, before the test.
- CollectProduce the sample by masturbation into the sterile pot provided. Do not use an ordinary condom.
- Deliver quicklyIf collected at home, keep the pot warm and get it to the lab ideally within one hour.
- Lab analysisStaff measure volume, then examine the sperm under a microscope for count, movement and shape.
- Review resultsYour doctor explains the report alongside your partner's tests and decides whether a repeat test is needed.
MedlinePlus describes two ways to collect a sample: masturbating into a sterile cup, or using a special collection condom supplied by your provider during sex. Ordinary condoms are not suitable.
Abstinence advice varies slightly between sources. MedlinePlus advises 2 to 3 days without ejaculation and no more than 5, because longer gaps can lower sperm quality. Always follow your own lab's instructions.
If you collect at home, MedlinePlus advises getting the sample to the lab within 30 minutes, keeping it close to body temperature, for example in an inside coat pocket.
Reading the results
The World Health Organization (WHO) laboratory manual, 6th edition (2021), gives lower reference limits. They are the lower 5th percentile of results from a reference population of fertile men, as summarised in a 2022 review.
| Measure | WHO 2021 lower reference limit |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration | 16 million per mL |
| Total motility | 42% |
| Normal forms (morphology) | 4% |
Reference limits are not fertility cut-offs. Researchers stress that the 5th percentile does not separate fertile from infertile men, and semen quality should be seen as a continuum.
Shape is a good example. ASRM notes that every man produces abnormal sperm, and up to half the sperm in a normal sample may be abnormally shaped. Some men with low morphology conceive without difficulty.
Labs can also judge shape using different systems. ASRM explains that strict (Kruger) criteria count small irregularities as abnormal, while WHO criteria are more lenient, so ask which system your report uses.
Besides the four main measures, the report may comment on other findings. MedlinePlus notes that abnormal acidity of the semen or white blood cells, which can point to infection, may also be reported.
What it feels like and how to prepare
The test is painless and needs no anaesthesia or recovery time. Most men find the hardest part is producing a sample on demand; it is normal to feel awkward, and staff are used to it.
- Count your abstinence days so they fall between 2 and 7.
- Collect the whole sample; tell staff if any was lost.
- Keep the pot near body temperature on the way to the lab.
- Tell your doctor about recent fever, illness or medicines.
- Don't use an ordinary condom to collect the sample.
- Don't let the sample get cold.
- Don't panic over a single result.
Risks and repeat testing
There are no physical risks. The main limitation is natural variation: results can differ from one sample to the next. If a repeat is needed, it is usual to wait about three months, the time it takes to make a new batch of sperm.
An abnormal result is a starting point, not a verdict. MedlinePlus notes that many causes of male infertility can be treated, and further tests may be needed to find the cause.
If results are low, options depend on the cause. For IVF, ASRM notes ICSI (injecting a single sperm into the egg) may be recommended when morphology is low.
Healthy habits may help overall health, but ASRM notes research has not shown a clear link between sperm shape and most lifestyle factors, and any changes take up to 3 months to show.
How DBN does it
At DBN, testing both partners is part of the first fertility assessment. The first consultation is free, and the cost of any tests is confirmed at that consultation.
When to see a doctor
- You have been trying to conceive for some time without success.
- You have had testicular surgery, injury, undescended testes or mumps affecting the testes.
- You notice a lump, swelling or pain in the scrotum.
- A previous semen analysis was abnormal.
Questions & answers
Can I collect the sample at home?
Sometimes, if the lab allows it. Keep the pot warm and deliver it ideally within one hour.
Does a result below the WHO limit mean I am infertile?
No. The limits describe typical results in fertile men, not a fertility threshold. Your doctor interprets them with your history and your partner's tests.
Why wait three months to retest?
It takes about three months to make a new batch of sperm, so a later test reflects a fresh cycle.
Related DBN services
Related articles
Sources
- The impact of different WHO reference criteria for semen analysis in clinical practice (Boeri et al., Andrology 2022) — Andrology / PubMed Central
- Sperm Test (Semen Analysis) — Patient.info
- Sperm morphology (shape): does it affect fertility? — ASRM ReproductiveFacts
- Semen analysis — MedlinePlus (U.S. National Library of Medicine)