How to interpret the semen analysis?

How to interpret the semen analysis?

Male infertility problems such as infertility in sperm or the less quantity of sperm may also cause infertility and hence are relevant to you. Therefore, one primary way of determining the cause of infertility is to undergo a sperm analysis test. The result of this test will help to determine a proper treatment plan for infertility and to improve the success rate for pregnancy.


The process of semen analysis

The two main components of semen are the sperm and the seminal fluid and these are produced by glands in the male reproductive system. The sperm analysis can be divided into two parts: Macroscopic examination and Microscopic examination. In the modern date technology, semen analysis is done by using computer systems to ensure both speed and accuracy.


Interpretation of semen analysis results

The doctor interpreting the results of a semen analysis will utilize information from the patient’s history such as medical history, smoking history, alcohol drinking history, underlying disease, etc. to assess the likelihood of male factors resulting in infertility. This interpretation is done by comparing the standard values stipulated by the World Health Organization given below with the values derived from the semen analysis.

1. Volume of semen: The volume of semen should be greater than or equal to 1.5 ml.

2.pH: It’s supposed to be a weak base with a normal value greater than or equal to 7.2.

3.Semen viscosity: Normal semen should have viscosity and the liquefaction or dissolution of the semen should take about 15-30 minutes.

4.Sperm concentration (number of sperms per 1 mL): Sperm concentration should be equal to or greater than 15 million per 1 mL.

5.Semen Color: Normally, semen should have a milky white appearance but, in some cases, it is seen that factors such as medication, blood, or urinary tract infection may result in change the semen color.

6.Sperm morphology: The assessment result is a sperm shape value, which the normal value according to WHO criteria is more than or equal to 4%

7.Sperm Motility and Viability: It is necessary that the sperm is motile to be able to fertilize naturally. Therefore, the semen analysis should at least show that 40% of the motile sperm. Also, at least 32% of the sperm should be viable and motile while there may be some sperm that are alive but are immobile. Hence, a further test for a proportion of live sperm is done in the analysis and the test should show that 58% or more of those sperms are viable.

8.White Blood Cell Count: The number of white blood cells in semen should not be more than 1 million cells per mL. White blood cell count in semen exceeding the normal 1 million mark may indicate an inflammation which can in turn infect the reproductive system.


Instructions for Semen Collection

For an effective semen analysis, semen has to be collected after the male has maintained good physical condition and has not fallen sick. This can be done by following the below instructions.

– Refrain from ejaculating semen at least 2 days but not more than 7 days before the semen analysis.

– Keep your genitals clean and wash your hands.

– Collect semen in a container from the laboratory, which is free from germs and chemicals that are harmful to sperm.

– Semen should not be collected in regular condoms as they may contain substances that are harmful to the sperm.

– If the semen is collected at home for analysis, the semen must be delivered to laboratory within 1 hour and in room temperature of 20-37°C. The semen should not be refrigerated.


Interpreting the results of a semen analysis should be done by a qualified medical professional to be able to plan a course of treatment or appropriate follow-up. It should be noted that each semen test may have different results depending on the physical condition of the male and other factors during the time of analysis such as healthy/unhealthy behavior, exercise, drug use etc.

Written by
Dr.Pokpong Pansrikaew
Obstetrician and Gynecologist, Reproductive Medicine