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TESTS · SEMEN ANALYSIS
He's usually tested last. We test him first.
A semen analysis looks at one fresh sample under the microscope: how much there is, how many sperm, how well they move and their shape. It is one of the simplest, cheapest tests in fertility care, and it can change the whole plan for a couple.
- For the male partner, at the start
- Sample takes minutes
- 2 to 7 days of abstinence first
- Repeated if abnormal
- Volume — 1.4 mL or more
- Count — 16 million per mL, 39 million in total
- Movement — 42% moving, 30% moving forward
- Shape — 4% normal forms
01What is a semen analysis and why is it done first?
A semen analysis measures the volume of one sample and the number, movement and shape of the sperm in it, and it is the main test for male fertility.
A male factor is part of the problem in many couples, so testing only the woman is not an assessment. The test is simple, painless and quick. Doing it first can save a woman months of tests and treatment that were never going to help.
02How do I give the sample, and what should I avoid?
Give the sample by masturbation into the sterile pot from the lab, after 2 to 7 days without ejaculation, and collect all of it.
The first part of the ejaculate carries most of the sperm, so losing it is the commonest reason for a falsely low count. Do not use lubricant, saliva or an ordinary condom; they harm sperm. If the sample is produced away from the clinic, it must reach the lab within an hour, kept close to body temperature and never refrigerated [CONFIRM: whether home collection is accepted]. Tell us about any fever, illness or antibiotics in the last three months.
03When should I do the test?
Any day of the week that falls 2 to 7 days after your last ejaculation, and not within a few weeks of a fever if you can help it.
Less than 2 days lowers the count; more than 7 lowers movement. Sperm take about two to three months to be made, so today's sample partly reflects how you were two months ago. A high fever can pull a result down for weeks afterwards.
04Why is one report not a diagnosis?
Sperm numbers change a lot in the same man from one sample to the next, so an abnormal result is repeated before anything is decided.
A fever, a course of antibiotics, heat, a difficult collection or a delay on the way to the lab can all make a report look worse than you are. The repeat is usually done a few weeks to 3 months later. A normal report does not promise fertility either: it does not measure DNA damage or whether sperm can fertilise an egg.
Honest note
The WHO limits are the lowest 5% of results from men whose partners conceived within a year. Five in every hundred of those fertile men scored below each line. A result under the line puts you in the lower part of a fertile range. It is not a diagnosis of infertility. (What the evidence says (WHO laboratory manual, 6th edition, 2021))
05Can home sperm test kits replace a lab test?
No. Most home kits give only a rough count, and the count alone misses movement, shape, volume and signs of infection.
A normal home result with poor movement is a common trap. A lab analysis following WHO methods is the test a doctor can act on. What you can change while you wait for a repeat is lifestyle.
Honest note
Male infertility: causes and what helpsLifestyle, led by a healthy weight. Then smoking, alcohol, about seven hours of sleep, stress, folic acid, and correcting thyroid, diabetes, blood pressure and vitamin D. (Dr Vani Sundarapandian, on the factors couples can influence most)
How to read your report
Units: Some labs still print the older WHO 2010 (5th edition) limits: volume 1.5 mL, 15 million per mL, 39 million total, 40% moving, 32% moving forward, 58% alive, 4% normal forms. The same sample can be flagged by one lab and not another purely because of the edition. Check which edition is printed on your report; if it is not, ask.
Abstinence (days)
Days since your last ejaculation before the sample.
- Reference
- WHO 2021 method: 2 to 7 days
- If outside
- Outside this window, the count or movement can read low. Repeat inside it before acting.
Volume (mL)
How much fluid the whole sample contains.
- Reference
- WHO 2021 lower reference limit: 1.4 mL
- If outside
- Low volume is usually a missed part of the sample or short abstinence. If it stays low, we check for a blockage or semen going backwards into the bladder.
pH
How acid or alkaline the semen is.
- Reference
- WHO 2021 manual: 7.2 or more
- If outside
- Low pH with low volume can point to a blockage near the end of the ducts.
Liquefaction
Semen starts as a gel and turns liquid so sperm can swim.
- Reference
- WHO 2021 manual: complete within 60 minutes
- If outside
- Slow liquefaction is noted and read with the rest of the report.
Sperm concentration (million/mL)
How many sperm are in each millilitre.
- Reference
- WHO 2021 lower reference limit: 16 million per mL
- If outside
- Below this is called oligozoospermia (low sperm count). It describes the sample, not your chance of a child.
Total sperm number (million per ejaculate)
Concentration multiplied by volume: all the sperm in the sample.
- Reference
- WHO 2021 lower reference limit: 39 million
- If outside
- This matters more than concentration alone, because concentration changes with volume.
Total motility, PR + NP (%)
The share of sperm that move at all.
- Reference
- WHO 2021 lower reference limit: 42%
- If outside
- Low movement with a normal count is often a delay or cooling on the way to the lab. Repeat first.
Progressive motility, PR (%)
The share of sperm swimming forward, the ones that can reach an egg.
- Reference
- WHO 2021 lower reference limit: 30%
- If outside
- Below this is called asthenozoospermia. This line is the most useful single figure for natural conception.
Non-progressive (NP) and immotile (IM) (%)
Sperm that twitch in place, and sperm that do not move.
- Reference
- No separate reference limit
- If outside
- Read together with the two motility lines above.
Vitality (% alive)
The share of sperm that are alive, checked when few are moving.
- Reference
- WHO 2021 lower reference limit: 54%
- If outside
- Many non-moving sperm that are alive points to a movement problem, not a production problem.
Normal forms, morphology (%)
The share of sperm with a normal head, midpiece and tail under strict criteria.
- Reference
- WHO 2021 lower reference limit: 4%
- If outside
- Most sperm look abnormal even in fertile men, which is why the limit is so low. Below it is called teratozoospermia. On its own it is rarely the whole story.
Round cells / leucocytes (pus cells) (million/mL)
White blood cells, which can signal infection or inflammation.
- Reference
- WHO 2021 manual: more than 1 million peroxidase-positive leucocytes per mL is raised
- If outside
- A raised count is followed up, often with a culture, and treated before repeating.
Agglutination
Sperm stuck to each other.
- Reference
- No reference limit; reported as present or absent
- If outside
- Heavy clumping can lower movement and is looked into.
Impression / conclusion
The lab's one-word summary, such as normozoospermia, oligozoospermia, asthenozoospermia, teratozoospermia, OAT or azoospermia.
- If outside
- A label, not a verdict. 'Azoospermia' (no sperm seen) must be confirmed on a spun-down sample and a second test before anyone uses the word.
Source of ranges: Reference limits: WHO laboratory manual for the examination and processing of human semen, 6th edition (2021). These are the 5th centile of fertile men, not targets and not a prediction of pregnancy.
What the result changes.
IfWithin the WHO limits
Attention moves to her tests and to how you are trying. If there are repeated failed cycles or miscarriages later, extra sperm tests may be discussed then.
What that meansIfMildly below the limits
We look for a cause (heat, infection, a varicocele, weight, smoking) and repeat the test after correcting it. With her tests normal, IUI can be a sensible first step.
What that meansIfWell below the limits (low count or poor movement)
A hormone profile and an examination. If counts are very low, genetic tests. ICSI can work with very few sperm.
What that meansIfNo sperm seen (azoospermia)
Confirmed on a spun-down sample and a second test. Then hormones, examination and a scan tell us if sperm are made but blocked, or not made; sperm can often be retrieved surgically.
What that meansIfVery low volume
A urine test after ejaculation checks whether semen is going backwards into the bladder, and we look for a blockage.
What that meansIfRaised pus cells
A culture and treatment of any infection, then a repeat analysis.
What that meansDo you need this test?
Do any of these sound like you?
- We've tried for 12 months (6 if she is 35 or over)
- She has had tests, he hasn't
- His report has numbers in red and we're worried
- We're about to start IUI or IVF
- He had a fever, surgery or a testicular problem
- A home sperm kit gave a result we don't trust
Your first visit
1
Talk
How long you've tried, any illness, heat or medicines, and any old semen reports.
2
Test
A semen analysis after 2 to 7 days of abstinence, the same week as her tests.
3
Plan
His report read next to hers. Repeat, treat a cause, or move to the right treatment.
4
Treat
Lifestyle and a repeat, IUI, or ICSI, depending on both of you, not on one number.
Questions patients ask
Still unsure? Ask us on WhatsApp — a real person replies.
What is a normal semen analysis report?
A report is within the WHO 2021 reference limits if it shows at least 1.4 mL of semen, 16 million sperm per mL (39 million in total), 42% moving, 30% moving forward and 4% normal forms. These are reference points from fertile men, not a pass mark, and a result below one line is not a diagnosis.
Where can I get a semen analysis test near me in Chennai?
Jananam takes semen samples at its Neelankarai centre on ECR and its Thiruporur clinic, in a private room [CONFIRM]. Message us on WhatsApp to book a time and get the preparation steps.
How many days of abstinence are needed before a sperm test?
Two to seven days without ejaculation is the WHO 2021 recommendation. Fewer than 2 days can lower the count, and more than 7 can lower movement.
Should a semen analysis be repeated?
Yes, if the first result is abnormal it is repeated, usually a few weeks to 3 months later, before any conclusion. Two samples are usually enough.
Can I collect the sample at home?
It is better to give the sample at the clinic, because it must reach the lab within an hour at close to body temperature. If you collect at home, use the lab's sterile pot, no lubricant or condom, and bring it straight in [CONFIRM: home collection accepted].
Does a bad semen report mean we need donor sperm?
Very rarely. Even a severely abnormal report can usually be treated with his own sperm, including with ICSI or sperm retrieved surgically.
I live in Sri Lanka. Can I do the sperm test there?
Yes, a recent semen analysis from a lab that follows WHO methods is usually accepted; send the full report before you travel. Dr Vani's team will tell you if a repeat is needed in Chennai.
Can I improve my sperm count?
Often, partly: stopping smoking and tobacco, cutting alcohol, treating infection, avoiding heat and reaching a healthy weight all help. Sperm take about three months to be made, so a repeat test after three months shows the change.
In their words, not ours.
Geetha M.
· Google
She prescribes only the very necessary investigations and medications, maintaining high standards and ethics.
Ankita P.
· Google
They won't put you in a loop and charge unnecessarily.
Test both of you, in the same week.
Book his semen analysis or send a report you already have. A real person from Dr Vani's team replies on WhatsApp, usually within minutes during clinic hours (Mon to Sat, 9am to 5pm. Sunday closed.).
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Sex selection is prohibited in India under the PCPNDT Act, 1994 and the ART Act, 2021.