How to Read a Sperm Analysis Report

Male fertility challenges are quite common among assigned males at birth AMAB. The most common cause of male infertility involves the health of the sperm. To determine the health of the sperm, a healthcare professional will order a semen analysis test to gain answers. Understanding what the test says is the first step in knowing how to treat or manage male infertility. 

Key Takeaways

• A semen analysis report can give you insight into fertility through key metrics like sperm count, motility, and morphology.
• Below-average results on a semen analysis report do not necessarily guarantee a person will struggle with infertility. Still, it can direct treatment and planning for those who are experiencing it.
• In many cases, low sperm count can be reversed with the adoption of healthy lifestyle habits.

What Is a Semen Analysis?

A semen analysis is a test done on assigned males at birth to analyze the overall health of the sperm. This analysis is used to gauge a male’s fertility or to see if a vasectomy was successful. The test looks at various parameters including:

• The volume of the sperm
• Number of sperms
• Movement or motility
• Shape of the sperm or morphology

All of these factors play an important role in a person’s fertility and are usually the first things looked at when infertility is suspected. 

How is a Sperm Analysis Done?

You must provide a semen sample before it is analyzed. To provide a sample, you will be required to masturbate and ejaculate into a sterile container. In order to optimize the quality of the sperm in the collection, the male is asked to abstain from having an ejaculation for a brief time before his collection that is to be analyzed.

The sample collection can be done in the privacy of your home or a private room at a fertility clinic. If you decide to do it at home, you can use an at-home semen analysis kit. A 2021 study found that these kits, though not comprehensive, still analyze two of the most important factors in sperm health- count and motility. 

In most cases, healthcare professionals in a clinic like  Ivy Fertility collect semen at least three times. This is because a male’s sperm count can vary from one day to the next and doing several tests will give clearer insight into the sperm’s health. 

The collected sperm is then sent to a laboratory where it is analyzed to test for infertility. It’s always important to remember that no matter what results you get, it doesn’t necessarily mean that you are infertile. It could just mean that there is a problem that can be fixed, sometimes with something as simple as a change in diet. 

Understanding Your Semen Analysis Report

When the tests are done, your healthcare professional will explain to you what each section of the results means. The semen analysis report contains the following key metrics. 

Sperm Concentration

This refers to the concentration of the sperm in the semen. A healthy ejaculation should have at least 39 million sperm, 58% of which are expected to live.

Semen Volume

When a man ejaculates, he releases a whitish-gray fluid called semen that contains sperm. One ejaculation contains 2 to 5 milliliters of semen. Some men have lower-than-average semen volume that according to a 2009 study usually reflects some underlying condition like hypogonadism or a blockage of the ejaculatory duct.

Sperm Motility

For successful fertilization, ejaculated sperm must be able to move quickly and freely past the cervix to the unfertilized egg. This is known as sperm motility. 

A detailed sperm analysis usually looks at whether the sperm is able to move in straight lines or large circles, also known as progressive motility or if they swim in very small circles, also known as non-progressive motility. According to the NIH, total motility in healthy sperm is normally around 40 percent, while progressive motility typically hovers around 32 percent or higher. 

When considering conception, the sperm must have progressive motility, which allows them to move at least 25 micrometers per second through the cervical mucus to reach and fertilize an egg. 

pH Scale

Sperm is considered alkaline, meaning it has a slightly basic pH, typically ranging between 7.2 and 8.0. A sperm analysis checks the levels of acids in your semen. If the semen sample is too acidic, it means there’s something wrong with the sperm and this can reduce one’s chances of having a successful pregnancy. 

Sperm Morphology

Sperm morphology refers to the size and shape of the sperm. The NIH says the threshold for healthy morphology is somewhere around 4 percent or more of the sperm in a sample having a normal structure and appearance. The sperm analysis will check how consistent the sperm’s biological structures are with typical semen. 

While it is not uncommon for sperm to develop in abnormal shapes or appear joined, too many anomalies can become problematic when one is trying to conceive. Nevertheless, such sperm can result in a healthy pregnancy. 

Liquefaction Time

Liquefaction time refers to how long it takes for your semen to become liquid. During ejaculation, semen should come out thick and then become more liquid. Normally, this process takes about 20 minutes. If the liquefaction process takes longer or your semen doesn’t become liquid at all, there could be a problem that needs rectification.

Sperm Count and Fertility

Sperm count is a key factor when looking at fertility but it’s not the only factor that affects it. Various studies have shown that higher sperm count is associated with higher levels of fertility. Additionally, those with higher concentrations of sperm (up to 40 million per milliliter) have increased fertility.

Thankfully, problematic semen is fixable.  Some of the most effective ways of boosting sperm count include:

• Losing weight
• Eating a healthy, balanced diet
• Increasing zinc and folate intake
• Regular exercise
• Stress management
• Getting the right amount of sleep
• Abstaining from alcohol and smoking

Bottom Line

A semen analysis is a great way to gain insight into a male’s fertility or any challenges you may be facing with conception. It looks at the sperm’s size, shape, count, and movement. Nevertheless, a semen analysis isn’t the only determinant of fertility, and some people with normal test results still struggle to conceive, while those with below-average results have no difficulty with conception.