Semen Analysis – What To Think About
A semen sample collected at home must be received at the laboratory or clinic within 1 hour. Keep the sample out of direct sunlight and do not allow it to get cold or hot. If it is a cold day, carry the semen sample container against your body to keep it as close to body temperature as possible. Do not refrigerate the semen sample. Consistently detecting sperm in the semen of a man who has had a vasectomy indicates that his surgery was not successful, and another form of birth control should be used to prevent pregnancy. A low number of sperm may be present in a semen sample taken initially after a vasectomy. However, sperm should not be present in subsequent samples. A man whose mother took the medicine diethylstilbestrol (DES) during her pregnancy with him has a greater-than-normal risk of being unable to father a child (infertile). Additional tests may include measuring hormone levels, such as testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), or prolactin. For more information, see the medical tests Testosterone, Luteinizing Hormone, Follicle-Stimulating Hormone, and Prolactin. Other fertility testing, including sperm penetration, the presence of antisperm antibodies, or analysis after sexual intercourse (postcoital), may be recommended for infertility problems. For more information, see the medical test Infertility Testing.
Why It Is Done
- To determine if a man has a reproductive problem that is causing infertility.
- To determine if a vasectomy has been successful.
- To determine if a vasectomy reversal has been successful.
How To Prepare
You may be asked to avoid any sexual activity that results in ejaculation for 2 to 5 days before a semen analysis. This helps ensure that your sperm count will be at its highest, and it improves the reliability of the test. If possible, do not avoid sexual activity for more than 1 to 2 weeks before this test, because a long period of sexual inactivity can result in less active sperm. You may be asked to avoid drinking alcohol for a few days before the test. Be sure to tell your health professional about any medications or herbal supplements you are taking.
Dr. Friedman recommends that his patients take the following supplements:
How It Is Done
How It Feels
Normal: 1.0–6.5 milliliters (mL) per ejaculation Abnormal: An abnormally low or high semen volume is present, which may sometimes cause fertility problems.
Normal: Less than 60 minutes Abnormal: An abnormally long liquefaction time is present, which may indicate an infection.
Normal: 20–150 million sperm per milliliter (mL)0 sperm per milliliter if the man has had a vasectomy Abnormal: A very low sperm count is present, which may indicate infertility. However, a low sperm count does not always mean that a man cannot father a child. Men with sperm counts below 1 million have fathered children.
Sperm shape (morphology)
Normal: At least 70% of the sperm have normal shape and structure. Abnormal: Sperm can be abnormal in several ways, such as having two heads or two tails, a short tail, a tiny head (pinhead), or a round (rather than oval) head. Abnormal sperm may be unable to move normally or to penetrate an egg. Some abnormal sperm are usually found in every normal semen sample. However, a high percentage of abnormal sperm may make it more difficult for a man to father a child.
Sperm movement (motility)
Normal: At least 60% of the sperm show normal forward movement.At least 8 million sperm per milliliter (mL) show normal forward movement. Abnormal: Sperm must be able to move forward (or “swim”) through cervical mucus to reach an egg. A high percentage of sperm that cannot swim properly may impair a man’s ability to father a child.
Normal: Semen pH of 7.1–8.0 Abnormal: An abnormally high or low semen pH can kill sperm or affect their ability to move or to penetrate an egg.
White blood cells
Normal: No white blood cells or bacteria are detected. Abnormal: Bacteria or a large number of white blood cells are present, which may indicate an infection.
Normal: 300 milligrams (mg) of fructose per 100 milliliters (mL) of ejaculate Abnormal: The absence of fructose in the semen may indicate that the man was born without seminal vesicles or has blockage of the seminal vesicles.
Low or Absent Sperm Count
What Affects the Test
Factors that can interfere with your semen analysis or the accuracy of the results include:
- Medicines, such as cimetidine (Tagamet), male and female hormones (testosterone, estrogen), sulfasalazine, nitrofurantoin, and some chemotherapy medicines.
- Caffeine, alcohol, cocaine, marijuana, and smoking tobacco.
- Herbal medicines, such as St. John’s wort and high doses of echinacea.
- A semen sample that gets cold. The sperm motility value will be inaccurately low if the semen sample gets cold.
- Exposure to radiation, some chemicals (such as certain pesticides or spermicides), and prolonged heat exposure.
- An incomplete semen sample. This is more common if a sample is collected by methods other than masturbation.
Not ejaculating for several days. This may affect the semen volume.