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A semen analysis measures the amount of semen and determines
the number and quality of sperm.
A semen analysis is usually one of
the first tests done to help determine whether a man has a problem that is
making it difficult for him to father a child. A problem with the semen or
sperm affects about one-third of the couples
who are unable to have children (infertile).
Tests that may be done during
a semen analysis include:
Volume. This is a measure of how much semen is present in one ejaculation.
Liquefaction time. Semen is a thick gel at the time of ejaculation,
but normally becomes liquid about 20 minutes after ejaculation. Liquefaction
time is a measure of the time it takes for the semen to liquefy.
Sperm count. This is a count of the number of sperm present per milliliter
of semen in one ejaculation.
Sperm morphology. This is a measure of the percentage
of sperm that have a normal shape.
Sperm motility. This is a measure of the percentage of sperm that can move forward
normally. The number of sperm that show normal forward movement in a certain
amount of semen can also be measured (this is called the motile density).
pH. This is a measure of the acidity (low pH) or alkalinity (high
pH) of the semen.
White blood cell count. White blood cells are not normally present in
semen.
Fructose level. This is a measure of the amount of a
sugar, called fructose, in the semen. The fructose provides energy for the
sperm.
This test is done on a sample of
semen.
Semen Analysis Results
Usually results of a semen analysis are available within a day. Normal values may vary from lab to lab.
Semen volume
Normal:
1.0–6.5
milliliters (mL)
per ejaculation
Abnormal:
An abnormally low or high semen volume may sometimes cause fertility
problems.
Liquefaction time
Normal:
less than 60 minutes
Abnormal:
An abnormally long liquefaction time may indicate an infection.
Sperm count
Normal:
20–150 million sperm per milliliter
(mL)
0 sperm per milliliter if the man had a vasectomy
Abnormal:
If the sperm count is very low, a man may be infertile. However,
a low sperm count does not always mean that a man cannot father a child. Men
with sperm counts below 1 million have fathered children.
Sperm shape (morphology)
Normal:
At least 60% of the sperm have normal shape and structure.
Abnormal:
Sperm can be abnormal in several ways, such as having two heads
or two tails, a short tail, a tiny head (pinhead), or a round (rather than
oval) head. Abnormal sperm may be unable to move normally or to penetrate
an egg. Some abnormal sperm are usually found in every normal semen sample.
However, a high percentage of abnormal sperm may impair a man's ability to
father a child.
Sperm movement (motility)
Normal:
At least 60% of the sperm show normal forward movement.
At least
8 million sperm per milliliter (mL) show normal forward movement.
Abnormal:
Sperm must be able to move forward ("swim") through cervical
mucus to reach an egg. If a high percentage of sperm cannot swim properly,
the man may find it difficult to father a child.
Semen pH
Normal:
Semen pH of 7.1–8.0
Abnormal:
An abnormally high or low semen pH can kill sperm or affect
their ability to move or to penetrate an egg.
White blood cells
Normal:
No white blood cells or bacteria are detected.
Abnormal:
The presence of bacteria or a large number of white blood cells
in semen can indicate an infection.
Fructose level
Normal:
300
milligrams (mg) fructose per 100 milliliters (mL) of ejaculate
Abnormal:
The absence of fructose in the semen may indicate that the man
was born without seminal vesicles or has blockage of the seminal vesicles.
If a low sperm count or a high percentage
of sperm abnormalities are found, further testing may be done. Other tests
may include measuring hormones, such as testosterone, luteinizing hormone (LH), follicle-stimulating
hormone (FSH), or prolactin. A small sample (biopsy)
of the testicles may be needed for further evaluation if
the sperm count or motility is extremely low.
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