Semen Analysis Test Results Explained

Take-home points

• Semen analysis evaluates sperm health through three main factors: concentration, motility, and morphology.
• Concentration indicates the number of sperm, motility assesses their movement, and morphology examines their shape.
• Healthy sperm is crucial for fertility, and these factors collectively indicate sperm quality.
• The World Health Organization (WHO) provides reference ranges to interpret results and determine their significance.

It's common to feel perplexed when you receive medical results that you can't fully comprehend. Don't worry; you're not alone in this situation. When it comes to semen analysis, there are three primary factors to focus on:

Sperm Concentration

This refers to the number of sperm per millilitre (ml) of ejaculate. During ejaculation, a man produces a mixture of sperm and seminal fluid. The total amount of fluid is the volume of the sample, typically ranging from 1.5 ml to 5 ml. The concentration is determined by assessing how many sperm are present per ml of ejaculate.¹ A minimum concentration of 15 million sperm per ml is considered desirable. Additionally, your results may include "total sperm number," which is calculated by multiplying the concentration by the sample volume. The total sperm number should be greater than 39 million.¹

Sperm Motility

This measures how well the sperm are moving. Motility is evaluated based on various parameters because sperm can be moving in different ways. These parameters include progressive, non-progressive, and immotile.¹ Progressive sperm move in the right direction, non-progressive sperm move but not in the right direction or go in circles, and immotile sperm do not move at all. Motility is expressed as a percentage, and the focus is on the motile/progressive sperm. To be within the normal range, a man should have 30% or more of his sample showing progressive motility.²

Sperm Morphology

Morphology refers to the shape of the sperm. The production of sperm in the testicles is not always efficient, resulting in many sperm having peculiar shapes. It is not uncommon for sperm to have abnormalities like two heads, two tails, a short tail, or no tail, among other issues. The morphology aspect of your results indicates how many of your sperm are considered "normal" in shape. Surprisingly, the number of normal forms is often quite low. To be within the normal range, you should have 4% or higher of sperm with a "normal" shape. This means that if you fall within the normal range, 96% of your sperm will be abnormal.¹

In summary, the minimum figures you should hope to see in your semen analysis test results are as follows:

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What if my semen analysis results are below normal values?

It's crucial to understand that if you fall below the normal range in any of these parameters, it may affect your chances of conceiving naturally or through assisted treatments. If you fall below the normal range in two or all three parameters, your chances of conceiving may be further reduced.

When undergoing a semen analysis, it is advisable to repeat the test a week or two later to establish a baseline for your results. If the results continue to be below the normal range, it is essential to investigate the potential causes. We recommend completing the free testhim health questionnaire, as it may identify key factors that could impact your sperm health.

Who to speak to about my semen analysis results?

While lifestyle and dietary changes can often yield positive results, if your semen analysis results are particularly concerning, we suggest seeking further investigations from an andrologist or urologist. Other medical and genetic factors can also influence sperm health, so a thorough medical history and examination are crucial. Keep in mind that these specialized services may not be readily available through the NHS, so you may need to seek assistance from a private andrologist or urologist.

You can slo read: DNA Fragmentation: The Complete Guide

For additional resources and support, please visit the testhim support page, which provides useful links and information.

‍TRTed is not financially supported by testhim in any capacity. testhim have a number of resources on their website to support men with infertility. If you have any questions, please don't hesitate to reach out to us at info@trted.org.

References

1. Wang C, Swerdloff RS. Fertil Steril 2014;102(6):1502–1507.
2. Dickey RP, et al. Fertility and Sterility 1999;71(4):684–689.