Semen tests analyze sperm count, shape, and motility to test for male factor infertility and assess the quality of your sperm. You can improve a low sperm count with medications or lifestyle changes.
Sperm count can be important if you’re trying to conceive a child. An abnormal sperm count may also indicate an underlying health condition.
A normal sperm count ranges from 15 million sperm to more than 200 million sperm per milliliter (mL) of semen. Anything less than 15 million sperm per milliliter, or 39 million sperm per ejaculate, is considered low. A low sperm count is often referred to as oligospermia. A high, or above average, sperm count is over 200 million sperm per millimeter.
You can determine your sperm count through a semen analysis. You can get the analysis done at your doctor’s office, a fertility clinic, or with an at-home test.
A semen analysis tests for the following:
- number of sperm (volume)
- shape of sperm
- movement of sperm, or “sperm motility”
The number, shape, and mobility of sperm are important for testing for male factor infertility. Your doctor may recommend testing up to three samples of sperm at different visits to get an accurate analysis.
At-home tests only test for the number of sperm. Talk to your doctor if you are interested in a full analysis.
Semen analysis results table
The following are the healthy or normal semen analysis results, as determined by the World Health Organization (WHO). Since results can vary from person to person, results are given as a range.
| WHO reference range | |
| Total sperm count in ejaculate | 39–928 million |
| Ejaculate volume | 1.5–7.6 mL |
| Sperm concentration | 15–259 million per mL |
| Total motility (progressive and non-progressive) | 40–81 percent |
| Progressive motility | 32–75 percent |
| Sperm morphology | 4–48 percent |
If you’re trying to conceive naturally, a healthy sperm count is often necessary. Even though it only takes one sperm and one egg to get pregnant, more healthy sperm will increase your chances of pregnancy each month.
Even if you aren’t trying to conceive, your sperm count may be an important measure of overall health. One study found men with a low sperm count were more likely to have a higher percentage of body fat (bigger waistline and higher BMI) and higher blood pressure than men with higher sperm counts. They also experienced a higher frequency of metabolic syndrome, or higher chance of developing diabetes, heart disease, and stroke.
For these reasons, if you’re diagnosed with a low sperm count, your primary care doctor may want to evaluate your testosterone levels, lifestyle, and overall health.
Sperm count can affect fertility because your chance of getting your partner pregnant decreases with a lower sperm count. Problems with the quality of sperm can also affect your chances of getting a woman pregnant.
Male infertility factor, often due to a low sperm count, is a common reason many couples have trouble conceiving. But couples may also experience other health issues that can affect fertility. In some cases, infertility may be due to female factors, like:
- low ovarian reserve
- a blocked fallopian tube
- endometriosis
Lack of conception may also be the result of not trying to conceive for long enough. In many cases, it can take six months to a year to get pregnant when there are no fertility concerns.
If you are over 35, and you and your partner have been trying to conceive for six months, your doctor may refer you to a fertility specialist. If you have been trying to conceive for over one year, and you and your partner are under 35, see your doctor for a referral.
Infertility or a low sperm count may be caused by a number of factors, including:
- genetics
- past surgeries
- general health
- sexually transmitted diseases
Your doctor can assess your sperm count and recommend treatment.
Possible treatment options include:
- Surgery. If you have a varicocele or obstructed vas deferens, surgical correction or repair may be recommended.
- Antibiotics. If a bacterial infection is affecting your sperm count or fertility, your doctor may prescribe antibiotics.
- Medication or counseling. These may be used for sexual intercourse problems such as premature ejaculation or erectile dysfunction.
- Hormone treatments and medications. For cases where high or low hormone levels influence infertility, hormone treatments may help.
While many causes of a low sperm count require medical intervention, lifestyle choices can also factor in. The following may improve sperm count:
- Lose weight. Being obese or overweight can cause a low sperm count. Try to maintain a healthy lifestyle through diet and exercise.
- Take vitamin supplements. Ask your doctor for a blood test to test for vitamin deficiencies. They may recommend adding new foods to your diet, or taking supplements to help restore vitamin and mineral levels.
- Avoid substance abuse, including heavy drinking and drug or tobacco use.
- Wear loose, cotton boxers.
There are many factors that can affect your sperm count, including lifestyle choices or underlying medical conditions. If you have a low sperm count, your doctor may recommend options for you to raise your sperm count, or they may refer you to a urologist or fertility specialist, if needed.
If you have a low sperm count and are hoping to conceive a child, there are many fertility options available today, including a range of treatments like:
- intrauterine insemination (IUI)
- in vitro fertilization (IVF)
- IVF with intracytoplasmic sperm injection (ICSI)
Talk to your doctor about your concerns and options.