SEMEN ANALYSIS: Everything you need to know

DO YOU KNOW THAT in humans, up to 15% of couples are infertile. This means they aren’t able to conceive a child, even though they’ve had frequent, unprotected sexual intercourse for a year or longer. In over ONE-THIRD of these couples, MALE INFERTILITY plays a role.
MALE INFERTILITY can be due to:

  • low sperm production
  • abnormal sperm function or
  • blockages that prevent the delivery of sperm.
  • Illnesses, injuries, chronic health problems and
  • lifestyle choices( smoking, excessive alcohol consumption, illicit drug use, obesity)

MALE FERTILITY is a complex process. Hence the need for a regular medical check to ascertain the number, morphology and motility of the sperm cells (semen analysis).

Semen analysis
Semen analysis is a test which analyses the health and viability of a man’s sperm. Semen is the fluid containing sperm (plus other sugar and protein substances) that’s released during ejaculation. A semen analysis measures three major factors of sperm health:

  • the number of sperm
  • the shape of the sperm
  • the movement of the sperm, also known as “sperm motility”

Two to three separate sperm analyses need to be conducted to get a good idea of sperm’s health. The tests should be conducted at least seven days apart and over the course of two to three months. Sperm counts can vary daily hence the need to take an average of the semen analysis results.

Why semen analysis?
Test for male infertility
A semen analysis is often recommended when couples are having problems getting pregnant. To get your partner pregnant, the following must occur:

  • There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner’s egg. A low sperm count is fewer than 15 million sperm per millilitre of semen 
  • Sperm must be functional and able to move. If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner’s egg. 
  • A male must produce healthy sperm.  Just because a man ejaculates during every sexual intercourse does not mean that the sperm produced are healthy and viable.

A semen analysis will help to determine if low sperm count or sperm dysfunction is the reason behind infertility.

Test for vasectomy success
Men who have had a vasectomy undergo a semen analysis to make sure no sperm are in their semen. In a vasectomy, the tubes that send sperm from the testicles to the penis are cut and sealed as a permanent form of birth control. After a vasectomy, doctors often recommend that men take a sperm analysis once a month for three months to ensure that sperm is no longer present in their semen

It’s very important to follow these instructions for accurate results.
To get the best sample:

  • semen should be collected after a minimum of 48 hours and no longer than 7 days of sexual abstinence.
  • Avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days before the test.
  • Stop taking any herbal medications
  • Avoid any hormone medications as instructed by your healthcare provider.
  • Discuss any medications you’re taking with your doctor.


The following guidelines should be observed while collecting sample for semen analysis:

  • The sample should be obtained preferably by masturbation and ejaculated into a clean, wide-mouthed glass or plastic container.
  • The container should be warm to minimize the risk of cold shock
  • Ordinary condoms must not be used for semen collection because they may interfere with the viability of spermatozoa. A non-spermicidal condom should be used instead.
  • Coitus interruptus (withdrawal method) is NOT acceptable as a means of collection because it is possible that the first portion of the ejaculate, which contains the highest concentration of spermatozoa, will be lost. Moreover, there will be cellular and bacteriological contamination of the sample and the acid pH of the vaginal fluid will adversely affect sperm motility.

Handling the sample
Two main factors are crucial to having a good testing sample.

  • In order to avoid inaccurate results, semen must be protected from extremes of temperature (not less than 20°c and not more than 40°c) while transporting to the laboratory.
  • semen must be delivered to the testing facility within 30 to 45 minutes of leaving the body.

Test interference
Some factors can negatively affect the test, including:

  • semen coming into contact with spermicide
  • taking the test when you’re ill or stressed
  • contamination of the sample

There are no known risks associated with sperm analysis.
If semen analysis results aren’t within normal limits and handling of the specimen isn’t a factor, your doctor may also consider whether you’re taking the following substances, which can affect your sperm count:

  • alcohol
  • caffeine
  • herbs
  • prescription drug use of medicines known to reduce sperm count, such as cimetidine
  • recreational drug use
  • tobacco

What are the normal results?
After the semen sample is collected, your test results should be ready within 24 hours. When a doctor reviews sperm analysis test results, there are many factors to consider. An analysis after vasectomy looks for the presence of sperm, but the analysis to look for fertility issues is much more in-depth. Your doctor will take each of the following results into account:

Sperm shape
A normal result for sperm shape is that more than 50 percent of sperm are normally shaped. If a man has greater than 50 percent of sperm that are abnormally shaped, this reduces his fertility. A laboratory may identify abnormalities in the sperm’s head, midsection, or tail. It’s also possible the sperm could be immature and therefore not able to effectively fertilize an egg.

For a normal result, more than 50 percent of sperm must move normally an hour after ejaculation. Sperm movement, or motility, is important to fertility because sperm must travel to fertilize an egg.

The pH level should be between 7.2 and 8.0. A pH level higher than 8.0 could indicate the donor has an infection. A result less than 6.5 could indicate the specimen is contaminated or in cases of agenesis (or occlusion) of the seminal vesicles.

The volume of semen for a normal result should be greater than or equal to 2mls. A low semen volume could indicate a low amount of sperm to fertilize an egg. An excess fluid volume could also mean the amount of sperm present is diluted.

It should take 15 to 30 minutes before semen liquefies. While semen is initially thick, its ability to liquefy, or turn to a watery consistency, helps sperm to move. If semen does not liquefy in 15 to 30 minutes, fertility could be affected.

Sperm count
The sperm count in a normal semen analysis should be between 20 million to over 200 million. This result is also known as sperm density. If this number is low, conceiving can be more difficult.

The appearance should be whitish to gray and opalescent. Semen that has a red-brown tint could indicate the presence of blood, while a yellow tint could indicate jaundice or be a medication side effect.


What do abnormal results mean?
Abnormal sperm will have trouble reaching and penetrating eggs, making conception difficult. Abnormal results could indicate the following:

  • infertility
  • infection
  • hormonal imbalance
  • disease, such as diabetes
  • gene defects
  • exposure to radiation

If your results come back at abnormal levels, your doctor will probably suggest that you take additional tests. These tests include:

  • hormone testing
  • urinalysis after ejaculation
  • taking a tissue sample from your testicles
  • anti-sperm immune cells testing

At e-Clinic & Diagnostics Ltd, we offer quality semen analysis investigation using the Sperm Quality Analyzer Machine which uses computer image processing technology and advanced artificial intelligence to carry out sperm quality analysis, accurately giving a comprehensive quantitative analysis of sperm activity and static characteristics in conformity with WHO international standards. It is suitable for clinical semen test and helps in providing an important scientific basis for male fertility.