There are 3 main things that a semen analysis checks:
Sperm count
Sperm motility (movement)
Sperm morphology (appearance/shape)
Why is a semen analysis needed?
It is usually done as part of fertility workup as a third of couples who have difficulty conceiving may have male factor related infertility.
Do I need to prepare for the test?
Abstain from sex, masturbation, alcohol, caffeine for at least 3 to 6 days before semen collection
Avoid herbal or hormone medications (discuss with your gynaecologist if you are on any medications)
How do I do this test?
The best way to collect semen for a semen analysis is through masturbation. You may opt to do it at home, or your designated lab will have facilities for you to collect there. A few tips:
Empty your bladder
Wash your hands and penis thoroughly with water (do not use soap)
Wipe dry with clean paper towels
Masturbate and collect the semen into the provided semen bottle
Keep bottle at room temperature
Submit bottle to the designated lab within 60 minutes of collection (if done at home)
If there was spillage during collection, do not attempt to collect the spillage to add to the bottle. You simply need to let the lab know that there was spillage.
What is considered a normal result for semen analysis?
The World Health Organisation values for a normal semen analysis is as follows:
Parameter
Lower reference limit
Semen volume (ml)
1.5 (1.4-1.7)
Total sperm no (106 per ml)
39 (33-46)
Sperm concentration (106 per ml)
15 (12-16)
Total motility (PR + NP, %)
40 (38-42)
Progressive motility (PR, %)
32 (31-34)
Vitality (live sperm, %)
58 (55-63)
Sperm morphology (normal forms, %)
4 (3-4)
pH
≥ 7.2
*PR: progressive motility, NP: non progressive
My semen analysis came back abnormal. Why is that?
This can be due to a variety of factors, including:
Your general health
Smoking and alcohol
Medical problems e.g. kidney disease, depression, cancer etc
Previous surgeries on testes: resulting in blockages
Genetic conditions: abnormal chromosomes affecting sperm production or male reproductive tract development
Retrograde ejaculation
Varicoceles (swollen veins in scrotum)
Infection e.g. sexually transmitted infections (STIs) or childhood infections (mumps)
Anti-sperm antibodies
Hormones: low levels of hormones required for sperm production (this may be caused by external factors e.g. taking steroids for bodybuilding)
Can I improve my sperm count?
This depends on the cause. Possible ways to do so include:
changing your lifestyle e.g. stop smoking/alcohol, improve control of your medical conditions, reduce stress, maintaining a healthy body mass index (BMI)
wear loose boxers
taking vitamins that boost male fertility: your gynaecologist will be able to advise you on this
medication or counselling
antibiotics: in cases of infection
surgery: if varicocele or blockages are detected
hormone medications: in certain cases
You may need to see a urologist for further advice.
What are my options for fertility?
There are many option of assisted reproductive techniques that can help with low sperm count including:
intrauterine insemination
in-vitro fertilisation
IVF with intracystoplasmic sperm injection (ICSI)
Depending on the results of your partner’s fertility check, your gynaecologist will be able to advise you further on this.
