How to Read a Sperm Analysis Report

Semen is a whitish-gray fluid released from a penis after a male has an orgasm. This fluid contains sperm (male reproductive cells), fluids that lubricate the urethra and make it possible to deposit sperm in a vagina, and nutrients (proteins, vitamins, and minerals) that fuel the sperm cells.

The most common cause of male infertility has to do with the health of the sperm and one of the main ways male infertility is diagnosed is through the semen analysis test. If you’ve recently had a semen analysis done, you may be anxiously trying to figure out what that analysis means.  Here, we will look at some of the terms mentioned in the semen analysis report and what each means in relation to the health of your sperm. 

Key Takeaways

• A semen analysis report can give you insight into fertility through key metrics like sperm count, motility, and morphology.
• Below-average results on a semen analysis report do not necessarily guarantee a person will struggle with infertility. Still, it can direct treatment and planning for those who are experiencing it.
• In many cases, low sperm count can be reversed with the adoption of healthy lifestyle habits.

What Is a Semen Analysis?

A semen analysis takes a sample of an individual’s semen and assesses several parameters to gather information about the person’s fertility. The test is mainly done during the process of trying to become pregnant or following a vasectomy to confirm if the procedure was effective. 

When you visit a clinic like Ivy Fertility, the healthcare professionals will take you through what the semen analysis process entails. 

The semen analysis test evaluates:

• Sperm count
• Sperm activity (motility)
• Sperm shape (morphology)

All of these factors play an important role in a person’s fertility, and they are usually the first thing that’s checked in cases where infertility is suspected in an individual who produces sperm naturally. 

After sperm is collected, the semen sample is sent to a laboratory where the factors mentioned above are assessed. However, it’s important to note that the absence of sperm or low sperm numbers does not necessarily indicate that a man is absolutely infertile. It could point to a hindrance to the production or delivery of the sperm

What to Expect During Semen Analysis Process

A semen sample must be provided to conduct a semen analysis. This typically requires you to masturbate and ejaculate into a sterile container, which can be done either at home or in a private room at a fertility clinic. The sample procured is then handed off to the lab for assessment. Results are usually available within a few days, depending on the type of test used and the lab analyzing it.

One can choose to use an at-home semen analysis kit if they would prefer privacy. While these kits typically don’t assess as many parameters as full lab analysis, a 2021 study found the kits were highly effective in analyzing sperm count and motility, two of the largest contributors to infertility.

While the results of a semen analysis don’t predict the viability of a natural pregnancy 100 percent of the time, they do offer some insight into potential problems that could arise along the way.

Understanding Your Semen Analysis Report

Once you receive the results of a semen analysis, the report will have a few key measures to understand if you’re seeking insight into your fertility level.

Semen Ejaculate Volume

A normal ejaculation contains between 2 and 5 milliliters of semen. While lower than average semen volume in and of itself is not necessarily a cause of infertility, a 2009 study found it is typically connected to some underlying condition such as hypogonadism, absence of the seminal vesicle, or a blockage of the ejaculatory duct.

Sperm Concentration

The total number of sperm in the semen sample can give a lab a good idea of how densely concentrated the sperm are in the sample. According to the National Institutes of Health, a healthy ejaculation should contain at least 39 million sperm, of which 58 percent or more should live.

Sperm Motility

It is not enough for sperm to be alive in the semen sample - to fertilize an egg, sperm need to be able to move of their own accord. Sperm motility refers to the sperm’s ability to move freely and, specifically, its ability to make its way past the cervix and to the unfertilized egg. 

There are two main types of sperm motility: 

• Progressive motility: This refers to sperm that tends to move in straight lines or large circles.
• Non-Progressive Motility: This refers to sperm that don’t move in straight lines. These sperm swim in very small circles.

For successful fertilization to occur, sperm must have progression motility which allows them to move at least 25 micrometers per second, through the cervical mucus to reach and fertilize an egg. The NIH states total motility is normally around 40 percent, while progressive motility typically hovers around 32 percent or higher in healthy samples.

pH scale

A male’s pH scale on a semen analysis refers to the levels of acids and bases in your semen. A semen sample that’s too acidic can affect the health of your sperm and reduce one’s chances of having a successful pregnancy. 

Time to liquefaction

During ejaculation, semen should come out thick. In a sperm analysis, liquefaction time measures how long it takes before your semen becomes liquid. Normally, this process takes about 20 minutes. If the liquefaction process takes longer or your semen doesn’t become liquid at all, there could be a problem that needs rectification.

Sperm Morphology

Sperm morphology refers to the size and shape of the sperm. Tests check how consistent the sperm’s biological structures are with typical semen as some sperm have anomalies that could be problematic when trying to fertilize an egg.

It is not uncommon for sperm to develop in abnormal shapes or for sperm to appear similar to two or more sperm cells fused. Large amounts of sperm in a sample can present this way and still lead to a healthy pregnancy. The NIH says the threshold for healthy morphology is somewhere around 4 percent or more of the sperm in a sample having a normal structure and appearance.

Sperm Count and Fertility

While sperm count is only one of the factors affecting a male’s fertility, it is still an important one. Different studies have proved that higher sperm count is associated with higher levels of fertility in those studied. Males with higher concentrations of sperm (up to 40 million per milliliter) have increased fertility.

How to Increase Sperm Count

Low sperm count is not necessarily unfixable for many people, and simple, consistent lifestyle changes have been found to produce great results for some individuals who scored poorly on that parameter of their semen analysis.

Some of the most effective ways of boosting sperm count include:

• Losing weight
• Eating a healthy, balanced diet
• Increasing zinc and folate intake
• Regular exercise
• Stress management
• Getting the right amount of sleep
• Abstaining from alcohol and smoking

Bottom Line

A semen analysis isn’t the only determinant of fertility, but it offers insight into any infertility challenges one may be facing. However, some people with normal test results still struggle to conceive, and some who have below-average results have no difficulty getting their partner pregnant.