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Logo: University of Missouri Women's Health Center-Reproductive Medicine & Fertility
Text: Semen Analysis...
Quantitative Semen Analysis
At least one in ten couples in the US experience infertility (lack of pregnancy after one year of unprotected intercourse).  In about half of these couples, there is a male factor involved.  Semen analysis (SA) is the standard test used to evaluate male fertility.  As part of an infertility evaluation of a couple, one or more SAs are performed.  If the first SA is not completely normal, additional SAs will be ordered, usually 2-3 weeks apart.
Getting ready for your semen analysis:
  • Your doctor will ask that you avoid ejaculation for 2-5 days before the appointment
  • Your semen quality will be better if you are able to collect your sample at our center.  Our collection rooms are private, sanitary and comfortable.
  • If home collection is necessary, please pick up a collection kit from our center.
  • After collection, the sample must be kept warm and brought to the lab within 30 minutes of collection.

SA involves measures made on the whole semen including pH, liquefaction time, color, odor, viscosity, and volume.  Microscopic measures are also made, including the concentration of sperm, presence of other cells in the semen, sperm motility, and sperm morphology.

The most important measures are the sperm concentration, motility and morphology.  The other measures can help diagnose the conditions that cause male infertility.

See our information sheet
Your Semen Analysis Results
The MS Word document includes the information below and has a chart for you to record your results
Explanation of Semen Analysis Results

Sperm Concentration or sperm count: Low sperm count is called oligospermia. The testicles in a normal man produce about 100 million sperm per day (about 1000 per heartbeat).  Depending on how often a man ejaculates, the number of sperm in a normal semen specimen ranges from about 40 million to 500 million sperm.  Sperm production involves many hormones and body systems.  There are hereditary, environmental and health conditions that can lower the number of sperm made by the testicles.  In some cases these are temporary or can be treated medically.  If you have oligospermia, your doctor may refer you to a Urologist for further evaluation.

Sperm Motility:  The swimming ability of sperm is required for their fertility.  In the laboratory, we count the number of sperm that have strong motility, those with slow motility, those that are motile but not swimming forward, and those that are not motile.  Sperm motility is considered normal if at least 29% (about one third) of the sperm are motile, and at least half of the motile sperm have good swimming speed.  A low number of motile sperm is most important when the sperm count is also low.  If the man’s sperm motility cannot be treated medically, it is possible to collect the best sperm from his semen and place them directly into the uterus (IUI) or place them with eggs (IVF).  In cases of very low motility, sperm can be injected into the egg (ICSI).

Sperm Morphology:  The size and shape of the sperm cell is called morphology.  Sperm with abnormal morphology are less able to perform the tasks required for normal fertility.  Our laboratory uses the “strict criteria”, which involves detailed evaluation of each sperm for normal size and shape of each sperm structure.   A value of less than 5% normal forms suggests reduced fertility.  Poor sperm morphology is particularly serious when the sperm count or motility is also low.  For more information, see the American Society of Reproductive Medicine (ASRM) booklet Sperm Shape (Morphology): Does It Affect Fertility?

OATSCases in which the sperm count, sperm motility and normal morphology are all low are the most difficult to treat. This combination is sometimes called oligo-astheno-terato-zoospermia syndrome, or OATS.

Semen volume and pH:  When ejaculation occurs, sperm from the testicles are propelled along the vas deferens, and the secretions of several glands are added.

The most important contributions to the semen volume are from the prostate gland and the seminal vesicles.  Abnormal function of these two glands can affect male fertility.  The prostate gland, which often becomes inflamed and enlarged in older men, normally produces a slightly acid fluid (low pH) that makes up about one quarter of the semen volume.  The seminal vesicles produce an alkaline (high pH) fluid that makes up almost three quarters of the semen.  Absence of, inflammation or damage to these organs can sometimes be detected by changes in the volume and/or pH of the semen.

Semen liquefaction:  Within a minute of ejaculation, the semen coagulates to form a soft gel.  This may help the semen remain  in contact with the woman’s cervix while the sperm migrate into the uterus.  Within about 30 minutes, the semen gel liquefies under the influence of an enzyme from the prostate gland.   Failure to liquefy measured in the laboratory can indicate a problem with the prostate gland.

Semen color and odor:  Abnormal color and/or odor of semen can indicate contamination with bacteria, blood or urine.  This information can be used by a Urologist to help diagnose the underlying problem in cases of abnormal semen analysis.

Semen viscosity:  Liquefied semen is normally a thick fluid, similar to blood or egg yolk.  However, in some cases the semen is like mucus and will form strings when it is drawn into a pipette.  This is called hyperviscosity and may trap sperm in the semen, preventing them from migrating into the uterus.  Hyperviscosity can be present in the semen of fertile men, but it is more common in cases of male factor infertility.  Very rarely, hyperviscosity is an indication that the man has one or more mutations of the gene that causes cystic fibrosis.  Your physician may suggest cystic fibrosis testing or genetic counseling for couples with semen hyperviscosity who are considering IVF.
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