What is a semen analysis?

A semen analysis, also called a sperm count, measures the quantity and quality of semen and sperm. Semen is the thick, white fluid released from the penis during sexual climax (orgasm). This release is called ejaculation. Semen has sperm, the cells made in the male reproductive system that carry half of the genetic material needed to make a baby.

Problems with the quantity or quality of your semen and sperm, such as low sperm count or sperm that don't move properly, can affect your sperm's ability to reach and fertilize an egg. An egg is the cell made in the female reproductive system that carries the other half of the genetic material needed to make a baby. Problems with your sperm's ability to fertilize an egg can cause infertility, which is the inability to conceive a baby after a year of trying.

Other names: sperm count, sperm analysis, semen testing, male fertility test

What is it used for?

A semen analysis helps your health care provider find out if there is a problem with your semen or sperm. This test checks your semen and sperm using a variety of measurements:

• Volume is the amount of semen in your sample.
• Sperm count is the number of sperm in the entire sample.
• Sperm concentration is the number of sperm present in a milliliter of semen.
• Sperm movement (motility) is the percentage of sperm that are moving efficiently (in a straight line or in large circles).
• Sperm shape (morphology) is the number of sperm that have a normal shape.
• pH describes the acidity of your semen.
• Time to liquefaction is how quickly your semen changes into a fluid.

Abnormal results in any of these measurements may be causing infertility.

The test may also be used to see if a vasectomy has been successful. A vasectomy is a surgery on the male reproductive system that's done for birth control. To prevent pregnancy, a vasectomy cuts the tubes that carry sperm out of your testicles (testes) so that the sperm can't get into your semen. A semen analysis is usually done 8 to 16 weeks after a vasectomy to make sure your semen has no sperm.

Why do I need a semen analysis?

You may need a semen analysis if:

• You and your partner have been trying to have a baby for at least 12 months without success.
• You've recently had a vasectomy and need to make sure that you don't have any sperm in your semen.

What happens during a semen analysis?

You will need to provide a semen sample. For accurate results, the semen must be examined quickly before the sperm begin to die. You will usually provide a sample in a private room at a lab by masturbating and collecting your semen in a sterile container.

To get accurate results:

• Urinate (pee) and wash your hands and penis before collecting your sample. This will keep bacteria from your skin out of the sample.
• Don't touch the inside of the container.
• Don't use lubricants or saliva. They could harm your sperm.
• Make sure to collect all the semen you produce. If you miss collecting any of it, let your provider know.
• Don't try to collect any semen that didn't make it into the container. This could contaminate the sample.

You may also collect a semen sample at home. The two main options are:

• At-home self-test kits. To use these, you collect a semen sample and follow the kit's instructions on how to do a sperm count. Some kits may also check motility and concentration. These tests are useful, but they can't provide as much information as a full semen analysis.
• Self-collection kits. To use these, collect a semen sample and send it to a lab. It is important that you keep the sample at room temperature and get it to a lab within one hour.

If you prefer, you may be able to collect your sample at home during sex by using a special type of condom that your provider gives you. But as with self-collection kits, you will have to keep the sample at body temperature and take it to the lab within 30 to 60 minutes after collecting. Be sure to follow any additional instructions your provider gives you. For example, you may need to transfer your sample from the condom to a sterile container.

Because your sperm count and semen quality can vary from day to day, you may need to provide two or more semen samples within a week or two. Talk with your provider if you have questions or concerns about providing a semen sample. You can also talk to your provider about which type of test you prefer.

Will I need to do anything to prepare for the test?

You'll need to avoid all sexual activity that results in ejaculating sperm for 2-7 days before the sample is collected. This will help make sure your sperm count is at its highest level. Your provider will give you instructions.

Are there any risks to the test?

There is no known risk to a semen analysis.

What do the results mean?

Results to check fertility:

Your semen analysis will include the measurements listed above. It will also often include the normal ranges for these measurements:

• Volume: 1.5 to 7.6 milliliters. Anything lower than 1.5 milliliters may cause infertility.
• Sperm count: More than 39 million sperm in the entire sample. A count lower than this may make it difficult to get your partner pregnant.
• Sperm concentration: 15 to 259 million sperm per milliliter of semen. Anything lower than 15 million may make it difficult to get your partner pregnant.
• Sperm movement (motility): Over 40%. If less than 40% of your sperm are able to move efficiently, the odds of one reaching and fertilizing the egg may be lower.
• Sperm shape (morphology): Over 4% of your sperm should have a normal shape. Sperm with abnormal shapes may not be able to fertilize an egg.
• pH: 7.2 to 8.0 pH. A pH outside of this range can kill sperm or affect their ability to move.
• Time to liquefaction: 15 to 30 minutes after collection. Your results may give a timeframe, or they may say normal.
• White blood cells (leukocytes): Less than 1 million white blood cells per 1 milliliter of semen. More than this may be a sign that an infection is affecting your fertility.

If your semen analysis results aren't all normal, it doesn't mean you're permanently infertile. But it does show that your sperm may be part of the reason you and your partner are having difficulties getting pregnant.

Your provider may order more tests, such as ultrasounds and blood tests, to help find the cause of the problem so it can be treated. There are many possible causes, including:

• Certain habits you may be able to change, such as smoking.
• A physical problem in your testicles, such as an enlarged vein (varicocele).
• Certain genetic disorders or other health conditions, including hormone disorders, diabetes, and cystic fibrosis.

Treatments for infertility depend on the cause. To help improve your chances of getting your partner pregnant, your provider may refer you to a provider who specializes in infertility.

Results for semen analysis to check a vasectomy:

The results of your semen analysis will tell you if there's any sperm in your semen. It's not unusual to find sperm in several ejaculations after a successful vasectomy.

• If sperm is found, you'll need repeat testing until your sample has no sperm. In the meantime, you and your partner will have to use other birth control to prevent pregnancy.
• If no sperm is found, you and your partner should be able to stop using other forms of birth control.

Learn more about laboratory tests, reference ranges, and understanding results.