Semen Analysis

What is a semen analysis?

A semen analysis, also called a sperm count, measures the quantity and quality of semen and sperm. Semen is the thick, white fluid released from the penis during sexual climax (orgasm). This release is called ejaculation. Semen contains sperm, the cells made in the male reproductive system that include the genetic material needed to make a baby.

If you and your partner haven't been able to get pregnant, a problem with semen or sperm may be one of the reasons. Problems such as a low sperm count or sperm that don't move properly can cause infertility, which is the inability to conceive a baby after a year of trying. A semen analysis can help figure out if a problem with semen or sperm is likely to be causing infertility.

Other names: sperm count, sperm analysis, semen testing, male fertility test

What is it used for?

A semen analysis is used to find out if a problem with semen or sperm may be causing infertility. The test may also be used to see if a vasectomy has been successful.

A vasectomy is a surgery on the male reproductive system that's done for birth control. To prevent pregnancy, a vasectomy cuts the tubes that carry sperm out of your testicles (testes) so that the sperm can't get into your semen. A semen analysis is usually done 8 to 16 weeks after a vasectomy to make sure your semen has no sperm.

Why do I need a semen analysis?

You may need a semen analysis if:

• You and your partner have been trying to have a baby for at least 12 months without success.
• You've recently had a vasectomy and need to make sure that you don't have any sperm in your semen.

What happens during a semen analysis?

You will need to provide a semen sample. For accurate the results, the semen must be examined quickly before the sperm begin to die. For this reason, you will usually provide a sample in a private room at a lab by masturbating and collecting your semen in a sterile container. You may be asked to urinate (pee) and wash your hands and penis before collecting your sample. This will help keep bacteria from your skin out of the sample.

To get accurate results:

• Don't use lubricants or saliva because they could harm your sperm.
• Make sure to collect all the semen you produce. If you miss collecting even a bit of it, you should let your provider know.

If you prefer, you may be able to collect your sample at home during sex by using a special type of condom that your provider gives you. But you will have to keep the sample at body temperature and take it to the lab within 30 to 60 minutes after collecting it.

You may need to provide two or more semen samples within a week or two. That's because your sperm count and semen quality can vary from day to day. Talk with your provider if you have questions or concerns about providing a semen sample.

Will I need to do anything to prepare for the test?

You'll need to avoid all sexual activity that results in ejaculating sperm for 2-7 days before the sample is collected. This will help make sure your sperm count is at its highest level. Your provider will give you exact instructions.

Are there any risks to the test?

There is no known risk to a semen analysis.

What do the results mean?

Results to check fertility:

Your semen analysis will include many measurements that describe your semen and sperm:

• Volume is the amount of semen in your sample. A low volume may cause infertility.
• Sperm count is the number of sperm in the entire sample. A low count may make it difficult to get your partner pregnant.
• Sperm concentration measures how close together the sperm are in your semen. A low concentration may be a sign of a problem.
• Sperm movement (motility) tells you the percentage of sperm that are moving forward. Sperm must be able to move forward to fertilize an egg.
• Sperm shape (morphology) is the number of sperm that have a normal shape. Sperm with abnormal shapes may not be able to fertilize an egg.
• pH describes the acidity of your semen. Abnormal acidity can kill sperm or affect their ability to move.
• White blood cells (leukocytes) in sperm may be a sign that an infection is affecting your fertility.

If your semen analysis results aren't all normal, it doesn't mean you're permanently infertile. But it does show that your sperm may be part of the problem you and your partner are having getting pregnant.

Your provider may order more tests to help find the cause of the problem so it can be treated. There are many possible causes, including:

• Certain habits you may be able to change, such as smoking
• A physical problem in your testicles, such as an enlarged vein (varicocele)
• Certain genetic disorders or other health conditions, including hormone disorders, diabetes, and cystic fibrosis

Treatments for infertility depend on the cause. To help improve your chances of having a baby, your provider may refer you to a doctor who specializes in infertility.

Results for semen analysis to check a vasectomy:

The results of your semen analysis will tell you if there's any sperm in your semen. It's not unusual to find sperm in several ejaculations after a successful vasectomy.

• If sperm is found, you'll need repeat testing until your sample has no sperm. In the meantime, you and your partner will have to use other birth control to prevent pregnancy.
• If no sperm is found, you and your partner should be able to stop using other forms of birth control.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a semen analysis?

There are several at-home kits that measure sperm count alone. Some kits provide more information, but none of them provide as much information as you get from an analysis that your provider orders.

With at-home self-test kits, you collect a semen sample and use the kit to do a sperm count on your own. Some kits also use a device that attaches to a smartphone to check how the sperm are moving and how dense they are in your semen.

With self-collection kits, you collect a semen sample at home to send to a lab. These tests provide more information than tests you do at home, but they don't replace a more complete semen analysis that your provider orders.