Semen Analysis

Your doctor will let you know what you should do in preparation for the semen analysis. It’s very important to follow these instructions for accurate results.

To get the best sample:

• Avoid ejaculation for 24 to 72 hours before the test.
• Avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days before the test.
• Stop taking any herbal medications, such as St. John’s wort and echinacea, as instructed by your healthcare provider.
• Avoid any hormone medications as instructed by your healthcare provider.

Discuss any medications you’re taking with your doctor.

You’ll need to provide your doctor with a semen sample for a semen analysis. There are four main ways to collect a semen sample:

• masturbation
• sex with a condom
• sex with withdrawal before ejaculation
• ejaculation stimulated by electricity

Masturbation is considered the preferred way to get a clean sample.

Getting a good sample

Two main factors are crucial to having a good testing sample. First, the semen must be kept at body temperature. If it gets too warm or too cold, the results will be inaccurate. Second, the semen must be delivered to the testing facility within 30 to 60 minutes of leaving the body.

Test interference

Some factors can negatively affect the test, including:

• semen coming into contact with spermicide
• taking the test when you’re ill or stressed
• lab technician error
• contamination of the sample

There are no known risks associated with a sperm analysis.

If semen analysis results aren’t within normal limits and handling of the specimen isn’t a factor, your doctor may also consider whether you’re taking the following substances, which can affect your sperm count:

• alcohol
• caffeine
• herbs, such as St. John’s wort
• prescription drug use of medicines known to reduce sperm count, such as cimetidine
• recreational drug use
• tobacco

Testing your semen at home

Home semen tests are available. However, they only test for sperm count. They don’t analyze sperm motility or shape. Find at-home sperm analysis tests here.

Results for at-home tests are usually available within 10 minutes. A normal sperm count (above 20 million sperm per milliliter of semen) from a home test doesn’t necessarily mean that a man is fertile, since it doesn’t consider all the possible causes of male infertility.

If you are concerned about your fertility, it’s best to get a lab test done by a medical professional. This will give you a more comprehensive evaluation of your fertility.

After your semen sample is collected, your test results should be ready within 24 hours to one week, depending on the laboratory you go to. When a doctor reviews sperm analysis test results, there are many factors to consider. An analysis after vasectomy looks for the presence of sperm, but the analysis to look for fertility issues is much more in depth. Your doctor will take each of the following results into account:

Sperm shape

A normal result for sperm shape is that more than 50 percent of sperm are normally shaped. If a man has greater than 50 percent of sperm that are abnormally shaped, this reduces his fertility. A laboratory may identify abnormalities in the sperm’s head, midsection, or tail. It’s also possible the sperm could be immature and therefore not able to effectively fertilize an egg.

Movement

For a normal result, more than 50 percent of sperm must move normally an hour after ejaculation. Sperm movement, or motility, is important to fertility because sperm must travel to fertilize an egg. An automated system analyzes the sperm for movement and rates them on a scale of 0 to 4. A score of 0 means the sperm are not moving, and a score of 3 or 4 represents good movement.

pH

A pH level should be between 7.2 and 7.8 to achieve a normal result. A pH level higher than 8.0 could indicate the donor has an infection. A result less than 7.0 could indicate the specimen is contaminated or that the man’s ejaculatory ducts are blocked.

Volume

The volume of semen for a normal result should be greater than 2 milliliters. A low semen volume could indicate a low amount of sperm to fertilize an egg. An excess fluid volume could also mean the amount of sperm present is diluted.

Liquefaction

It should take 15 to 30 minutes before semen liquefies. While semen is initially thick, its ability to liquefy, or turn to a watery consistency, helps sperm to move. If semen does not liquefy in 15 to 30 minutes, fertility could be affected.

Sperm count

The sperm count in a normal semen analysis should be between 20 million to over 200 million. This result is also known as sperm density. If this number is low, conceiving can be more difficult.

Appearance

The appearance should be whitish to gray and opalescent. Semen that has a red-brown tint could indicate the presence of blood, while a yellow tint could indicate jaundice or be a medication side effect.

Abnormal sperm will have trouble reaching and penetrating eggs, making conception difficult. Abnormal results could indicate the following:

• infertility
• infection
• hormonal imbalance
• disease, such as diabetes
• gene defects
• exposure to radiation

If your results come back at abnormal levels, your doctor will probably suggest that you take additional tests. These tests include:

• genetic tests
• hormone testing
• urinalysis after ejaculation
• taking a tissue sample from your testicles
• anti-sperm immune cells testing

A semen analysis that’s the most conclusive requires careful collection and analysis of multiple specimens. The test can provide a variety of information that could help determine factors that affect your fertility. If your test results are abnormal, your doctor may recommend that you see a fertility specialist.