How to Read a Sperm Analysis Report

Male infertility remains under-discussed yet commonly encountered. Multiple factors influence fertility and this type of infertility is diagnosed using several tests, the most common being the sperm analysis report. The sperm analyses report is used to pinpoint sperm-related issues. For most people, the results of the sperm analysis can be hard to read, and although your doctor interprets the details, decoding the report yourself empowers you with deeper insights.

Key Takeaways

• A semen analysis report can give you insight into fertility through key metrics like sperm count, motility, and morphology.
• Below-average results on a semen analysis report do not necessarily guarantee a person will struggle with infertility. Still, it can direct treatment and planning for those who are experiencing it.
• In many cases, low sperm count can be reversed with the adoption of healthy lifestyle habits.

What Is a Sperm Analysis?

A sperm analysis examines semen quality and sperm count. During the test, semen—a cloudy, grayish fluid expelled during ejaculation—is collected and evaluated. Produced in testicles, sperm are essential reproductive cells containing genetic material crucial for conception.

A sperm cell consists of:

• Head: Holds DNA and specialized enzymes (acrosomes) for penetrating the egg.
• Middle: Houses mitochondria, supplying energy for the journey.
• Tail: Propels the sperm toward the egg.

The procedure itself is straightforward. Doctors typically recommend abstaining from sexual activity for about 2-3 days beforehand to maximize sperm concentration.

A sperm analysis is usually done at a fertility clinic like Ivy Fertility, although there are at-home analysis kits for those who would prefer the privacy of their homes. The donor collects the semen via masturbation into a sterile container or specially-designed condom if done at home. Prompt delivery to the lab within 30 minutes is critical.

Upon receipt, the sample is handed off to the lab for assessment and the sample must be examined within 2 hours of the collection. The earlier the sample is analyzed the more reliable the results. The lab specialist will look at:

• Liquefaction (how quickly semen transitions to liquid)
• Viscosity (semen thickness)
• Movement of the sperm (motility)
• Sperm count and morphology (structure)
• Semen volume

The analysis can be done at any time including after a vasectomy to confirm if the procedure was effective. Results are usually available within a few days, depending on the type of test used and the lab analyzing it.

How to Read a Sperm Analysis Report

The sperm analysis report has the following. 

Sperm Concentration

According to the National Institutes of Health, a healthy ejaculation usually contains at least 39 million sperm, of which 58 percent or more should live. Sperm concentration, or density, represents the number of sperm per volume unit (sperm cells per milliliter (mL) of semen). 

Your doctor will look at sperm concentration to gain a better understanding of the number of sperm present per milliliter of semen. Low sperm concentration, also known as oligospermia, is below 15 million sperm per milliliter. Low sperm concentration can be caused by various factors, including hormonal imbalances, genetic issues, infections, environmental toxins, and lifestyle choices.

Semen Ejaculate Volume

Semen ejaculate volume refers to the total amount of semen released during an ejaculation. This volume is measured in milliliters and ranges from around 1.5 to 5 milliliters per ejaculation. According to a 2009 study, low ejaculate volume can be connected to underlying conditions like hypogonadism, absence of the seminal vesicle, or a blockage of the ejaculatory duct. It can also be caused by age, prostate issues, and dehydration.

Sperm Motility

Sperm motility refers to the sperm’s ability to swim up through the vagina to the fallopian tubes for fertilization. For successful fertilization to occur, sperm must be able to travel through the female reproductive tract to reach and fertilize the egg.

There are two main types of sperm motility: 

• Progressive motility refers to the sperm’s ability to move in straight lines or large circles.
• Non-Progressive motility where sperm don’t move in straight lines but in very small circles.

Generally, sperm must have progressive motility (movement of at least 25 micrometers per second), and at least 40% of sperm in a sample should be moving. Low sperm motility or asthenozoospermia, can indicate low sperm motility, which can negatively impact fertility.

Sperm Morphology

Sperm morphology refers to the size, structure, and shape of the sperm. During a semen analysis, the doctor examines the characteristics of sperm under a microscope, looking at the shape of the head, the presence of a midpiece, and the structure of the tail. 

Normal sperm have an oval-shaped head and a long, straight tail, while abnormal sperm may have misshapen heads or tails, which can affect their ability to reach and penetrate an egg.

Sperm can develop in abnormal shapes but even such sperm can lead to a healthy pregnancy. The threshold for healthy morphology is somewhere around 4 percent or more of the sperm in a sample having a normal structure and appearance.

pH scale

The pH scale refers to whether the semen is acidic or alkaline. The normal pH range for semen is between 7.2 and 8.0. Healthy sperm should be in a slightly alkaline environment. If it’s too acidic it can affect the health of your sperm and reduce your chances of conception. 

Time to liquefaction

During ejaculation, semen is normally thick. Time to liquefaction is the time it takes for semen, which is initially thick and gel-like, to become liquid. This typically happens within 15 to 30 minutes and is important in sperm motility and fertility. If the liquefaction process takes longer or your semen doesn’t become liquid at all, there could be a problem. 

White blood cells

White blood cells help your body fight infection and disease. They are produced in your bone marrow and are part of your immune system. The presence of white blood cells in a semen analysis may be a sign of infection or inflammation.

Sperm analysis results

Sperm analysis results can differ among men. Nevertheless, in most cases, normal results are:

• Volume: Greater than 1.5 to 5.0 milliliter per ejaculation
• pH level: 7.2 to 7.8
• Sperm count: 39 million sperm per ejaculate or more
• Progressive motility: Greater than 32%
• Sperm morphology: More than 4% normal shaped sperm
  

An abnormal result does not always mean infertility. However, if the sperm count is very low or very high, a man may be less fertile. The acidity of the semen and the presence of white blood cells can affect fertility. Thankfully, many of the causes of male infertility are treatable.

Bottom Line

When someone assigned male at birth has trouble conceiving, it might be linked to male infertility. To investigate fertility issues, a doctor typically recommends a sperm analysis, a specialized test examining sperm health. A sperm analysis looks at an individual’s sperm count, motility, and shape. It’s important to note that the absence of sperm or low sperm numbers does not necessarily indicate that a man is infertile. It could point to a hindrance to the production or delivery of the sperm.