Understanding Your Semen Analysis Report

Key Takeaways

• About one-third of couples struggling to conceive face male-factor infertility.
• A semen analysis, combined with a medical history review, provides a clear picture into male fertility and helps guide treatment options.
• Your fertility specialist will help you interpret the results, but it's important to understand the key parameters. 
• Suboptimal results don't always mean infertility. Assisted reproductive technology such as in vitro fertilization and ICSI can often help.

What Is a Semen Analysis?

A semen analysis, also known as a sperm analysis, looks at a semen sample under a microscope to evaluate factors such as:

• Sperm Count: The number of sperm present.
• Sperm Motility: How well the sperm move.
• Sperm Morphology: The shape and structure of the sperm.

Other aspects like semen volume, acidity, liquefaction time, and levels of white blood cells might also be assessed. These results provide valuable insights into potential fertility issues and can help guide your treatment plan.

What to Expect During a Semen Analysis

For the most accurate and reliable results, follow the exact guidelines you’re given to prepare for your semen analysis. We instruct patients to abstain from ejaculating for two to five days before the test. This helps ensure your sperm count will be at its highest.  You'll provide the semen sample in a private room at the clinic, using a sterile container. A trained technician will then assess various sperm parameters under a microscope. Sometimes, patients like to use a home testing semen analysis kit as a first step on their own. Although these at-home tests do not cover all parameters of a full lab analysis, studies show they can detect sperm count levels and motility, which are key fertility factors.

Understanding Your Semen Analysis Report

When your semen analysis report is released from the lab, it will contain several important parameters. Here are the key ones to know:

Sperm Count and Concentration

Sperm count, closely linked to sperm concentration (or density), is a commonly discussed factor. It’s determined by evaluating semen under a microscope. Generally, higher sperm counts are associated with higher fertility as shown in this study, but only up to a certain point. Typically, a normal sperm density falls between 15 million and 200 million sperm per milliliter of semen. If the count is below 15 million per milliliter or 39 million in total per ejaculate, it's considered low. In some cases, men may have an absence of sperm, which is referred to as azoospermia.

Semen Ejaculate Volume

The amount of semen can vary between individuals and even with each ejaculation. On average, men produce between 1.25 and 5.00 mL of semen (about 1/4 to 1 teaspoon). The World Health Organization (WHO) considers less than 1.5 mL to be below normal. Factors such as age, smoking, alcohol consumption, overall health, sleep, diet, and ejaculation frequency can affect semen volume.

Sperm Motility

Motility, or sperm movement, is crucial for pregnancy. Sperm must swim efficiently through the cervix, uterus, and fallopian tubes to reach the egg. Motility is assessed by overall motility and progressive motility (sperm’s ability to move forward). Typically, healthy samples show around 40% total motility and 32% progressive motility.

Sperm Morphology

Morphology involves examining the shape and structure of sperm under a microscope. Normal sperm have a smooth head shaped like an oval, a cap that’s well-defined, and no visible abnormalities. Interestingly, most men produce a significant number of abnormally shaped sperm, as outlined by the American Society for Reproductive Medicine. The World Health Organization considers 4% or more of normal-shaped sperm as standard. When abnormal sperm exceeds 96%, it’s called teratozoospermia. Different labs may have varying thresholds for what they consider normal.

Increasing Your Sperm Count

To improve a low sperm count, consider making these lifestyle changes. They have shown promising results for many:

• Weight Management: Shedding excess weight can boost sperm count. A healthy diet and regular exercise are key.
• Nutrition: A nutrient-rich diet, especially with zinc and folate, supports sperm production.
• Exercise: Regular physical activity promotes overall health and reproductive function.
• Stress Reduction: Managing stress through relaxation techniques, mindfulness, or hobbies can help improve sperm production.
• Quality Sleep: Adequate, restful sleep is crucial for hormonal balance and overall well-being.
• Avoid Alcohol and Smoking: Abstaining from alcohol and smoking positively impacts sperm count.
• Avoid Testosterone: Using testosterone can reduce sperm count, as it signals the brain to stop producing sperm.

Remember, individual results may vary, but these lifestyle changes can contribute to better sperm health.

Bottom Line

When couples face challenges in conceiving, male-factor infertility is often a significant aspect. A semen analysis is a standard procedure, accompanied by a thorough medical history review. Your doctor will guide you through understanding the results of any tests and explore your fertility treatment options with care. Thanks to advances in reproductive medicine, many paths to parenthood exist even with suboptimal sperm test results, including in vitro fertilization (IVF) with ICSI.

This information is intended for educational purposes only and does not constitute medical advice. Please consult a qualified fertility specialist to discuss your individual situation and test results.