Semen analysis, also known as a sperm count test, analyzes 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 male 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”
Doctors will often conduct two or three separate sperm analyses to get a good idea of sperm’s health. According to the American Association for Clinical Chemistry (AACC), the tests should be conducted at least seven days apart and over the course of two to three months. Sperm counts can vary on a daily basis. Taking an average of the sperm samples can give the most conclusive result.
A semen analysis is often recommended when couples are having problems getting pregnant. The test will help a doctor determine if a man is infertile. The analysis will also help determine if low sperm count or sperm dysfunction is the reason behind infertility.
Men who have had a vasectomy undergo 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.
Your doctor will let you know what you should do in preparation for the semen analysis. It’s very important to follow these instructions for accurate results.
To get the best sample:
- avoid ejaculation for 24 to 72 hours before the test
- avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days before the test
- stop taking any herbal medications, such as St. John’s wort and echinacea, as instructed by your healthcare provider
- avoid any hormone medications as instructed by your healthcare provider
Discuss any medications you’re taking with your doctor.
You’ll need to provide your doctor with a semen sample for a semen analysis. There are four main ways to collect a semen sample:
- sex with a condom
- sex with withdrawal before ejaculation
- ejaculation stimulated by electricity
Masturbation is considered the preferred way to get a clean sample.
Getting a Good Sample
Two main factors are crucial to having a good testing sample. First, the semen must be kept at body temperature. If it gets too warm or too cold, the results will be inaccurate. Second, the semen must be delivered to the testing facility within 30 to 60 minutes of leaving the body.
Some factors can negatively affect the test, including:
- semen coming into contact with spermicide
- taking the test when you’re ill or stressed
- inexpert lab technician
- contamination of the sample
There are no known risks associated with a 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 you’re taking the following substances, which can affect your sperm count:
- herbs, such as St. John’s wort
- prescription drug use of medicines known to reduce sperm count, such as cimetidine
- recreational drug use
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:
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. An automated system analyzes the sperm for movement and rates them on a scale of 0 to 4. A score of 0 means the sperm are not moving, and a score of 3 or 4 represents good movement.
A pH level should be between 7.2 and 7.8 to achieve a normal result. A pH level higher than 8.0 could indicate the donor has an infection. A result less than 7.0 could indicate the specimen is contaminated or that the man’s ejaculatory ducts are blocked.
The volume of sperm for a normal result should be greater than 2 millimeters. A low sperm 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.
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.
Abnormal sperm will have trouble reaching and penetrating eggs, making conception difficult. Abnormal results could indicate the following:
- 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:
- genetic tests
- hormone testing
- urinalysis after ejaculation
- taking a tissue sample from your testicles
- anti-sperm immune cells testing
A semen analysis that’s the most conclusive requires careful collection and analysis of multiple specimens. The test can provide a variety of information that could help determine factors that affect your fertility. If your test results are abnormal, your doctor may recommend that you see a fertility specialist.