Semen Analysis for Male Fertility: What You Need to Know

A semen analysis is the first diagnostic test for male infertility, evaluating sperm count, motility, and morphology. WHO guidelines define normal sperm concentration at 15 million/mL, with progressive motility exceeding 32%. Abnormal results may indicate conditions like varicocele or hormonal imbalances, but require follow-up testing for accurate diagnosis.

Key Takeaways

Semen Analysis Procedure: How to Prepare and Collect a Sample

Patients must abstain from ejaculation for 2-7 days before the test and collect samples via masturbation into a sterile container. Avoid lubricants and ensure samples are analyzed within one hour of collection to maintain accuracy, as improper handling can skew results.

Interpreting Semen Analysis Results: Key Parameters and WHO Guidelines

Normal semen analysis ranges include 15+ million sperm/mL (concentration), 40%+ total motility, and 4%+ normal morphology. Values below these thresholds may suggest oligospermia, asthenozoospermia, or teratozoospermia, but require corroboration with additional tests.

Common Causes of Abnormal Semen Analysis Results in Men

Low sperm count (oligospermia) can stem from varicocele, hormonal imbalances, or genetic disorders like Klinefelter syndrome. Retrograde ejaculation and testicular trauma also contribute, while lifestyle factors such as smoking, obesity, and toxin exposure negatively impact sperm quality.

Beyond Semen Analysis: Advanced Male Fertility Tests Explained

Follow-up tests like karyotyping for chromosomal abnormalities, seminal leukocyte analysis for infections, and sperm penetration assays may be recommended. These identify underlying issues not detected by standard semen analysis, such as anti-sperm antibodies or DNA fragmentation.

Next Steps After Abnormal Semen Analysis Results: Treatment Options

Treatment options include intrauterine insemination (IUI) for mild abnormalities or IVF with intracytoplasmic sperm injection (ICSI) for severe cases. Addressing lifestyle factors, hormone therapy, or surgical interventions (e.g., varicocele repair) may also improve fertility outcomes.

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