How to Read a Sperm Analysis Report

When an assigned male at birth struggles to conceive, they may be struggling with male infertility. To check for male infertility, a doctor will ask for a sperm analysis to test the health of the sperm. For most people, the results of the sperm analysis can be hard to read, and while your doctor can explain the results, you should also understand what the report says. 

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 Sperm Analysis?

A semen analysis is a test that looks at the volume and quality of sperm. The test involves collecting a semen sample and evaluating it in a lab. Semen is a whitish-gray fluid released from a penis after a male ejaculates. The fluid contains sperm, which are produced in the testicles and also released during ejaculation. Sperm are found in semen and as the male sex cells, they carry genetic information responsible for reproduction. 

The sperm contains:

• The head: This has DNA and acrosomes that help penetrate the egg
• Middle: This part has mitochondria that provide energy for the tail 
• Tail: This moves the sperm towards the egg when ejaculated in a vagina

How is a Sperm Analysis Done?

A semen analysis is quite a simple procedure. To have enough sperm count, doctors recommend that you avoid any sexual activity that causes ejaculation  2 to 3 days before the test. 

A sperm analysis is usually done at a fertility clinic like NOVA IVF, although there are at-home analysis kits for those who would prefer the privacy of their homes. To get the sample, the man will be required to masturbate and ejaculate into a sterile container, or a condom if they are getting the sample from home. The sample should be handed over to the lab within 30 minutes.

After, the sample is handed off to the lab for assessment and the sample must be examined within 2 hours of the collection. The earlier the sample is analyzed the more reliable the results. The lab specialist will look at:

• How the semen turns to liquid
• Resistance to flow (viscosity)
• Movement of the sperm (motility)
• Number and structure of the sperm
• Volume of semen

The analysis can be done at any time including after a vasectomy to confirm if the procedure was effective. Results are usually available within a few days, depending on the type of test used and the lab analyzing it.

How to Read a Sperm Analysis Report

The sperm analysis report has the following. 

Sperm Concentration

Your doctor will look at sperm concentration to gain a better understanding of the number of sperm present per milliliter of semen. The National Institutes of Health, a healthy ejaculation usually contains at least 39 million sperm, of which 58 percent or more should live.

Semen Ejaculate Volume

Semen ejaculate volume refers to the total amount of semen released during an ejaculation. This volume is measured in milliliters and ranges from around 1.5 to 5 milliliters. According to a 2009 study, low ejaculate volume can be connected to underlying conditions like hypogonadism, absence of the seminal vesicle, or a blockage of the ejaculatory duct. 

Sperm Motility

Sperm motility refers to the sperm’s ability to swim up through the vagina to the fallopian tubes for fertilization. Fertilization largely depends on how fast sperm move towards the egg. 

There are two main types of sperm motility: 

• Progressive motility refers to the sperm’s ability to move in straight lines or large circles.
• Non-Progressive motility where sperm don’t move in straight lines but in very small circles.

For successful fertilization, sperm must have progression motility which allows them to move at least 25 micrometers per second. Normal motility is approximately 40 percent, while progressive motility is usually 32 percent or higher in healthy samples.

Sperm Morphology

Sperm morphology refers to the size and shape of the sperm. Sperm can develop in abnormal shapes but even such sperm can lead to a healthy pregnancy. The threshold for healthy morphology is somewhere around 4 percent or more of the sperm in a sample having a normal structure and appearance.

pH Scale

The pH scale refers to whether the semen is acidic or alkaline. The normal pH range for semen is between 7.2 and 8.0. Healthy sperm should be in a slightly alkaline environment. If it’s too acidic it can affect the health of your sperm and reduce your chances of conception. 

Time to Liquefaction

During ejaculation, semen is normally thick. Time to liquefaction refers to the time it takes for semen to become liquid after ejaculation. 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. 

White Blood Cells

White blood cells help your body fight infection and disease. They are produced in your bone marrow and are part of your immune system. The presence of white blood cells in a semen analysis may be a sign of infection or inflammation.

Sperm Analysis Results

Sperm analysis results can differ among men. Nevertheless, in most cases, normal results are:

• Volume: Greater than 1.5 to 5.0 milliliter per ejaculation
• pH level: 7.2 to 7.8
• Sperm count: 39 million sperm per ejaculate or more
• Progressive motility: Greater than 32%
• Sperm morphology: More than 4% normal shaped sperm

An abnormal result does not always mean infertility. However, if the sperm count is very low or very high, a man may be less fertile. The acidity of the semen and the presence of white blood cells can affect fertility. Thankfully, many of the causes of male infertility are treatable.

Bottom Line

Male infertility is more prevalent than many talk about and several factors can affect a man’s fertility. A sperm analysis used to rule out that sperm is the issue and gives the doctor insight into any infertility issues someone may be facing. A sperm analysis looks at an individual’s sperm count, motility, and shape. It’s important to note that the absence of sperm or low sperm numbers does not necessarily indicate that a man is infertile. It could point to a hindrance to the production or delivery of the sperm.