Semen analysis
A semen analysis is the first and main test of male fertility. A lab checks a sample for how much semen there is, how many sperm it contains, how well they move, and what share are a normal shape, comparing each against WHO reference limits. One below-limit result is not a diagnosis: values vary a lot between samples, so a repeat test is usually advised before drawing conclusions.
A semen analysis is usually the first test of male fertility, and it is simple, quick, and important: male-factor problems contribute to a large share of cases, so testing both partners early saves time. The sample is examined in a lab and the results are compared against reference limits published by the World Health Organization.
What it measures
The main things a lab looks at, with the WHO 2021 lower reference limits:
| Lower limit (WHO 2021) | |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration | 16 million per mL |
| Total motility (moving) | 42% |
| Progressive motility (moving forward) | 30% |
| Normal shape (morphology) | 4% normal forms |
A result at or above a limit sits within the reference range; one below it is flagged for a closer look. Concentration is how many sperm are present, motility is how well they swim, and morphology is the share with a normal shape.
How to read the result
For the most reliable sample, clinics usually ask for 2 to 7 days without ejaculation beforehand, and for the sample to reach the lab quickly and kept warm.
What low results can mean
If repeat tests confirm a low result, the next steps depend on which values are affected and by how much. Options range from lifestyle changes and treating an underlying cause, to IUI for mild issues, or IVF with ICSI for more significant male-factor problems. Even where there is no measurable sperm in the semen (azoospermia), sperm can sometimes be retrieved directly and used. A specialist can explain what fits.
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