Semen analysis is an important tool for identifying and treating possible causes of infertility. In fact, up to 50% of all couples struggling with infertility have some form of male factor infertility present. A semen analysis can help pinpoint potential challenges and offer insight into treatment options. Here is a guide to semen analysis: what to expect, how it works, and what it looks for.
Semen Analysis Vocabulary
There are several useful terms to understand when discussing semen analysis:
- Sperm: reproductive cells produced in the testicles. A single sperm can fertilize an egg to develop an embryo
- Semen: fluid that contains sperm and other proteins
- Semen Volume: the amount of semen produced in a sample
- Sperm Concentration/Sperm Count: the amount of sperm per milliliter (mL) of semen
- Motility: movement
- Morphology: shape & size
How Does Semen Analysis Work?
Most clinics will ask you to go to their facility to provide a semen sample through masturbation in a private room. Some clinics may allow for at home collection, but this can affect the accuracy of the test results. Follow your clinic’s directions for ejaculation and abstinence before your collection appointment – typically the clinic will ask you to ejaculate within a week, but not within 1-2 days, of the test.
The clinic sends the sample to a lab for tests and examination under a microscope. The lab sends the results back to the fertility specialist, who then calls you to discuss the results.
At PNWF, we conduct all semen analyses in our own in-house andrology lab. This allows us to coordinate analysis and treatment while maintaining the highest quality control standards.
What Does Semen Analysis Look For?
The semen sample is assessed in four main categories: volume, concentration, motility, and morphology.
Semen volume does not appear to impact fertility as much as some of the other factors. In some cases, low semen volume may result from how the sample was collected – for instance, if the patient didn’t abstain beforehand, or did not collect all the sample into the collection container. In fairly rare cases, low semen volume can point to a condition called “retrograde ejaculation,” where semen is released backwards into the bladder instead of ejaculated.
Concentration refers to the amount of sperm in each milliliter of sperm, and “typical” concentration has a huge range – from the tens to the hundreds of millions! Many people think of concentration, or “sperm count,” as the most important indicator of male fertility. While higher concentration can improve the chances of conception up to a point, it doesn’t tell the whole story. Rather, it’s important to consider concentration alongside the other factors – we’ll take a closer look at this later in the article.
Motility refers to the sperm’s ability to move, and is one of the more important factors for male fertility. In order to conceive naturally, sperm have to swim up the vagina, past the cervix, through the uterus and into the fallopian tubes, where they can find an egg to fertilize. So, to make it all the way to the eggs, sperm have to be able to “swim” effectively.
There are three kinds of motility, with different typical ranges. The first, “progressive motility” means the sperm’s ability to move forward. “Non-progressive motility” refers to sperm that move, but don’t swim forward. Finally, “Total motility” takes these two values and adds them together.
In a semen analysis, morphology refers to what percentage of the sperm have a “normal” size and shape. However, there is a wide range of what is considered normal, and what is an acceptable percentage of standard morphology. In fact, some studies suggest that morphology may not play a very large role in fertility. 4-39%
What Do My Results Mean?
We recommend that you wait to discuss your semen analysis results with your fertility doctor, rather than try to jump right into interpreting them yourself. This is for two reasons:
- Different clinics will give you different answers as to what are considered high, low, or standard values, sometimes with a very wide range.
- There often isn’t a clear line between a single factor and chances of conception. Having a factor in the lower range doesn’t automatically mean you will struggle conceiving.
A semen analysis provides a holistic picture of your sperm health that can inform your overall fertility options. Ultimately, the relationship between the factors is just as important as any single number.
That being said, for a very broad starting point, the “typical” range for each factor is as follows:
- Semen Volume: 1.4 – 6.2mL
- Concentration: 16 – 208 million/mL
- Motility: There are different kinds of motility, with different typical ranges for each kind.
- Progressive: 30-77%
- Non-progressive: 1-32%
- Total: 42-90%
- Morphology: 4-29%
Your doctor will go over your specific results and discuss next steps. This might include another analysis, additional tests, behavioral adjustments or medical treatments to improve sperm factors. If needed, procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF) can help people with male factor infertility conceive.
Concerned About Male Infertility? PNWF Can Help.
Semen analysis is just the first step in planning your path to parenthood. Set up a consultation today to learn about your options.