A semen analysis is one of the most important first steps in understanding male fertility. It measures how well your sperm are performing across several areas, including count, motility (movement), and morphology (shape).
This gives your fertility specialist a clear starting point, and can help to guide any next steps that may be recommended. .
Fertility difficulties can involve a male or female factor, or sometimes a combination of both. Having a semen analysis early on can help to provide answers sooner, making next steps feel a little clearer and helping you to move forward with confidence.
At Concept Fertility in Wandsworth, near Putney, South West London, your sample is assessed by our team of highly qualified embryologists, and you’ll receive a full Semen Analysis Report with a clear summary of your results to help you understand what they mean.
What Is a Semen Analysis?
A semen analysis (sometimes known as a sperm test) is a laboratory examination of a semen sample. Your embryologist looks at the sample under a microscope and records detailed measurements and qualities of your sperm, including how many there are, how they move, and their shape.
You may have a semen analysis on its own, or it may form part of a broader male fertility assessment.
How to Prepare for Your Semen Analysis
Getting the sample right from the start matters. Please abstain from ejaculation for 2 to 5 days before your appointment. Too short a window and your count may be lower than usual; too long and motility can be affected.
What Happens During the Semen Analysis Appointment
When you arrive at Concept Fertility, let reception know you’re here for your appointment. You’ll be shown to a private room with a sterile sample pot, and we’ll make sure you’re not disturbed. Once you’ve finished, leave the pot in the room, and the embryology team will collect it for processing.
The embryology team then conducts a series of macroscopic and microscopic evaluations, and you’ll receive your report summarising the results.
Macroscopic Evaluation: Volume, Liquefaction, and pH
Before looking at sperm under the microscope, your embryologist carries out a visual assessment of the sample itself.
Volume is measured first. A normal semen volume is typically between 1.4 and 5.0 ml. A volume below 1.4 ml is called hypospermia and may indicate an issue with the seminal vesicles or the prostate gland.
Liquefaction is checked next. Semen is thick and viscous immediately after ejaculation, which helps deposit sperm in one location. After a few minutes, it should liquefy into a free-flowing liquid, although this process can take up to 60 minutes.
Incomplete liquefaction isn’t necessarily a cause of infertility on its own, but it can indicate that the seminal vesicles or prostate may not be functioning as expected.
Your embryologist also records the pH and appearance of the sample. Semen should be slightly alkaline, at a pH of 7.2 or greater; a reading below this may suggest a problem related to the seminal vesicles or point to prostatitis, which is inflammation of the prostate gland. The sample should appear white or slightly off-white and translucent, as an opaque appearance may indicate an infection.
WHO Reference Values for Semen Parameters
The World Health Organisation (WHO) sets the reference values used to assess whether a semen sample falls within the normal fertile range.
The values below are drawn from the WHO’s 6th edition laboratory manual (2021), which is the current standard used by fertility clinics. Your report will measure your results against these thresholds.
| Parameter | Normal reference value (WHO 6th ed., 2021) |
| Volume | 1.4ml or more |
| Sperm concentration | 16 million+ |
| Total sperm count | 39 million+ |
| Total motility | 42%+ |
| Progressive motility | 30+ |
| Normal morphology | 4%+ |
| pH | 7.2+ |
Understanding Abnormal Results: Count, Motility and Shape
A result below any of the above values doesn’t mean you can’t conceive, but it gives your consultant the information needed to help you build a path forward.
If any of your results fall outside the normal range, your report will use specific medical terms to describe each finding.
A sperm concentration below 16 million per mL is called oligozoospermia, or low sperm count. It reduces your chances of conceiving each month, though it doesn’t rule out pregnancy.
Azoospermia means no sperm were detected in a sample. This could indicate an issue with the sample itself, or, if there is an underlying condition, there may be options available, including further investigation or sperm retrieval.
Motility is a useful predictor of fertility as sperm need to travel to reach the egg. Asthenozoospermia, or poor sperm motility, occurs when fewer than 42% of sperm are actively swimming, or fewer than 30% are able to make forward progress.
Teratozoospermia means fewer than 4% of your sperm meet the WHO’s standard morphological criteria for normal shapes. While this sounds alarming, considering millions of sperm are in a typical ejaculation, this still means that many normally shaped sperm will be present.
Depending on your results and medical history, your consultant may recommend further tests for conditions such as:
- Varicocele: Enlarged scrotal veins that may impact sperm production or count.
- Retrograde ejaculation: A muscle issue that causes semen to go backward into the bladder during ejaculation.
- DNA fragmentation: Genetic damage or breaks in sperm DNA.
- Haematospermia: Blood found in semen. While often harmless, it can be caused by an infection or inflammation.
Advanced Diagnostics: Round Cells and Immune Factors
Your semen analysis report may also include findings on round cells and antisperm antibodies.
Round cells is a catch-all term for non-sperm cells found in a sperm sample, including white blood cells and immature sperm cells that have not yet grown a tail.
Antibodies are proteins produced by the immune system that bind to foreign invaders in the body such as viruses and bacteria. They are one of the ways in which the body discriminates between self and non-self, and we would not normally expect them to bind to our own cells.
However, antisperm antibodies do, in some cases, mistakenly target and attack sperm. The mixed antiglobulin reaction (MAR) test is included in routine semen analyses and can detect antisperm antibodies.
Treatment Options After Abnormal Sperm Analysis Results
An abnormal semen analysis is not the end of your fertility plans. For many males, it’s a starting point that indicates where some areas might need further investigation, or reveal the right treatment.
Your consultant may recommend a repeat test, because semen quality can vary from one sample to the next and environmental factors may have impacted the first set of results. Lifestyle factors, too, such as diet, smoking, alcohol consumption, or heat exposure, may also play a role, and changes could be part of your plan going forward.
If necessary, your consultant will talk you through the treatment options that are most likely to help. These might include in vitro fertilisation (IVF) to bring eggs and sperm together in a laboratory setting; Intrauterine insemination (IUI), which implants sperm into a uterus at the time of ovulation; or Intracytoplasmic sperm injection (ICSI), which selects a single, healthy sperm for implantation in an egg.
Book a Semen Analysis or Male Fertility Consultation
If you would like to understand more about your fertility, you can book a semen analysis on its own or as part of a wider fertility assessment.
Our experienced embryology team at Concept Fertility in Putney, South West London, is here to guide you through every stage of your fertility journey.
Book a Male Fertility Consultation
To speak to our team, call 020 3388 3000 or book a free 15-minute mini consultation to discuss your options.