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Semen analysis

Male fertility plays a part in nearly half of all infertility cases and can affect approximately 7% of all men. A semen analysis is one of the tests that should be offered to help determine if there is an underlying cause of difficulties conceiving. Here we’ll explain why you may have an analysis performed and what the results could mean. 

 

What is semen?

Semen is the thick cloudy, white fluid that comes from a man’s penis when they ejaculate. It contains seminal fluid which carries sperm cells out of a man’s body so they can fertilise an egg in order to create a pregnancy. 

 

What is a semen analysis? 

A semen analysis is a test performed to evaluate semen and sperm. The semen is collected by masturbation into a sterile pot, usually within a fertility clinic setting. The test will analyse the volume, how many sperm there are (concentration), how the sperm are moving (motility) and how they are shaped (morphology).  

 

Why have a semen analysis?

If you and your partner are having trouble getting pregnant, one of the first tests your doctor will likely ask for is a semen analysis. The aim of the test is to identify if semen is a factor affecting your fertility. It can also help determine what treatment type (if any) may be most suitable. 

 

What do the results mean? 

The World Health Organization has guidance on how to interpret semen analysis, which your doctor may refer to. The results are often presented in a report and should include:

  • Volume
    Volumes between 1.5 and 5 mL would be considered normal. 
  • Concentration
    Concentration is the number of sperm in one mL of semen. 15 million sperm per mL or more is considered normal.
  • Total sperm count
    The total sperm count is the total number of sperm found in the entire ejaculate. 39 million sperm or more would be considered normal.
  • Motility
    Motility measures the percentage of sperm that are moving. 40% or more moving sperm in the sample would be considered normal.
  • Morphology
    Morphology refers to how the sperm look based on the shape of the head, the midpiece and the tail. 4% or more normal forms is considered normal. 

If the results are within the reference range, you may be encouraged to continue trying to conceive through intercourse for a total of 2 years before any treatment is offered. If the results show low sperm quality, you may be referred for additional tests or a repeat semen analysis, as results can vary between ejaculates. You may be referred for fertility treatment funded by the NHS after you have been trying for a total of 1–2 years.

 

How to access a semen analysis

Your GP should refer you for a semen analysis if you’ve been trying to conceive for 1 year. You may be referred earlier if there’s a reason to think the sperm count may be low. Alternatively, you could pay for a private semen analysis or a home sperm test.

 

Additional resources

We know that fertility investigations and treatment can be a challenging experience for men. A 2017 survey from the Fertility Network UK found that most respondents felt it affected their mental wellbeing, self-esteem and relationships. Visit HIMfertility https://fertilitynetworkuk.org/himfertility/ for more information and support. 

 

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