Understanding Your Semen Analysis

DISCLAIMER: This discussion is intended to educate patients and health care professionals about semen analysis results but is not a substitute for a consultation with a physician about the appropriate evaluation and treatment of male-factor infertility.

The semen analysis is merely a “snapshot” of male reproductive status, much like assessing the weather on a certain day by looking out the window. Excellent results on a semen analysis may predict normal male fertility at that point in time but does not guarantee male fertility a few years from now. Similarly, poor semen analysis results may not indicate poor male fertility forever. Multiple behavioral, medical, and environmental factors may interfere with sperm performance. Since sperm is produced every 85 days, removal of factors that negatively affect sperm performance may take that long to create an improvement on the semen analysis. Similarly, if the male is exposed to harmful factors, it may take almost 3 months to see deterioration of sperm performance.

The American Society for Reproductive Medicine (ASRM), in a 2012 publication (Fertility and Sterility 98(2):294-301, 2012), determined the lower limits of the accepted reference values for a semen analysis:

Sperm Concentration (count)   15 million per ml 
Sperm motility  40%
Sperm strict morphology (shape) 4%

Other factors of importance are volume of ejaculate, pH (acidity), the presence of sperm agglutination (“sticking together”), viscosity (thickness of fluid), and the presence of white blood cells (indicating infection or inflammation).

If one or more of the parameters above are abnormal (lower than above), attention should be paid to the presence of male factor infertility and investigative and possibly therapeutic action should be initiated. This includes counseling and education regarding factors that can be harmful for sperm performance, and possible evaluation and treatment by a urologist knowledgeable about male infertility. Many factors can hurt sperm performance. Lifestyle changes may sometimes be required to help improve sperm. While at least half of cases of sperm problems are unexplained, some of the common factors reducing sperm performance are as follows:

  • Excess heat (frequent use of hot tub, heavy clothing with prolonged sitting)
  • Testosterone use
  • Extreme stress
  • Medical illness (e.g. diabetes)
  • Infections (sexually-transmitted diseases, prostate infections, urinary tract infections)
  • Environmental toxins (heavy metals, paint products, herbicides, pesticides)
  • Marijuana, heavy smoking, heavy tobacco chewing, heavy drinking
  • Genetic causes (e.g. Y-chromosome abnormalities)
  • Varicocele (dilated veins in the scrotum)
  • Hormone abnormalities (e.g. thyroid and prolactin problems)
What should I do if my semen analysis results are abnormal?
  1. Repeat the semen analysis in 2-3 months (especially if certain lifestyles are identified as a possible cause, e.g. especially testosterone use, and can be changed in the interim).
  2. Consult with your physician about your results and about possible referral to a urologist or a reproductive specialist.
  3. Read about male factor infertility (e.g. Fertility and Sterility 98(2):294-301, August 2012.) and educate yourself. Learn to identify environmental and lifestyle changes that may be beneficial for sperm performance.
  4. Please remember that Bennett Fertility Institute (BFI) at INTEGRIS is a testing facility but cannot provide you with interpretation of your test results unless you make an appointment with one of its affiliated physicians (Dr. Kallenberger and Dr. Reshef at 405-945-4701). The physician who ordered the test should be the first one to contact regarding results and further referral.

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Oklahoma's largest hospital network
3300 N.W. Expressway
Oklahoma City, OK 73112 Phone: (405) 951-2277
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