His sperm count is normal. Does that mean his sperm are fine?

A normal count tells you there are enough sperm in the sample; it says nothing on its own about how well they swim, their shape or the DNA inside them.

A semen report measures volume, count, total movement, forward movement, shape, how many are alive, and signs of infection or clumping. A report can have a count well above the WHO reference limit and still have too few sperm swimming forward. That is the line to check next.

The commonest findings with a normal count are poor forward movement, a low share of normal shapes, low volume, and raised pus cells.

Poor forward movement (asthenozoospermia) means fewer sperm can reach the egg. A low share of normal shapes (teratozoospermia) is flagged often and matters less than it sounds. Low volume is usually a missed part of the sample, but if it stays low it needs checking. Raised pus cells can point to an infection, which is treated before the test is repeated.

No. Most sperm look abnormal even in fertile men, so a low morphology result on its own is rarely the whole story.

The WHO 2021 lower reference limit for normal forms is 4 in every 100 sperm. A result below it is read together with count and movement, and repeated before it changes anything. On its own it is not a reason to jump straight to IVF.

A semen analysis cannot see breaks in the DNA inside the sperm head, and it cannot show whether sperm will fertilise an egg.

Sperm with damaged DNA can look normal and swim well. A sperm DNA fragmentation test can measure this, but guidelines do not advise it for every man, and the UK fertility regulator (HFEA) cannot rate it as an add-on because good evidence is lacking. The American urology and fertility guideline does advise it after recurrent miscarriage. We use it only when the answer would change what we do: after recurrent miscarriage, repeated poor embryos, or unexplained infertility once both of you are fully tested.

At her tests and at your timing, because a normal semen report moves the question to ovulation, tubes, egg reserve and the womb.

That means a scan, hormone tests, a tube check and an egg reserve test, if she has not had them. It also means checking you are having sex in the fertile days, which is harder than it sounds with irregular cycles or long working hours. If every test for both of you is normal, that has a name, unexplained infertility, and a plan of its own.

Sperm take about two to three months to be made, so changes he makes now show up in a test about three months from now.

Stopping smoking and tobacco, cutting alcohol, keeping laptops and hot baths away from the groin, treating any infection and reaching a healthy weight all help. A fever can pull a result down for weeks, so a bad report after an illness is repeated. A varicocele, a swelling of the veins above a testicle, is checked on examination when the report is abnormal.