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Semen analysis

Last updated: March 7, 2019

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Semen analysis is an important test in the evaluation of male infertility and is also used to confirm sterility after a vasectomy. A semen sample is examined for sperm concentration, morphology, motility, and semen biochemistry (e.g., pH level). Test results can include a number of pathologies, such as low sperm count (oligospermia) or complete lack of sperm in the ejaculate (azoospermia). However, semen analysis is not a definitive test for infertility and low sperm count does not necessarily rule out the ability to father children.

  • The man is asked to abstain from sex/masturbation for 2–7 days before a semen sample is collected to maximize the quantity of the ejaculate and concentration of the sperm .
  • Semen is collected after masturbation into a sterile container .
  • Semen analysis should be performed within an hour of sample collection.
  • Semen analysis should be repeated in 12-week intervals (minimum of 2 separate samples) .

References:[1][2]

Semen analysis

Characteristics Normal findings
Volume 1.5 - 5 mL
Color Whitish, opalescent
Liquefaction Complete within 30 minutes
pH

Basic 7.2–8.0

Total number of sperm per ejaculate > 39 million per ejaculate
Sperm concentration per mL > 15 million per mL
Vitality (percentage of live sperm) > 58% live sperm
Morphology (percentage of normal forms) > 4% sperm are morphologically normal.
Total motility (progressive and non-progressive sperm) > 40%
Progressive motility > 32%
Fructose in seminal plasma > 13 μmol/L
Leukocytes per mL of semen < 1 million

Pathological findings

Conditions Characteristics
Aspermia No ejaculate
Hypospermia Low ejaculate volume (< 1.5 mL)
Azoospermia No spermatozoa in the ejaculate
Cryptozoospermia < 1 million spermatozoa/mL of ejaculate
Oligospermia < 15 million spermatozoa/mL of ejaculate
Asthenozoospermia < 32% of spermatozoa show progressive motility (category PR)
Teratozoospermia Increased amorphous spermatozoa
Oligoasthenoteratozoospermia (OAT syndrome) Low concentration, insufficient motility, and increased amorphous spermatozoa

References:[1][2][3]

  1. Faraj K. Male Infertility. In: Kim ED, Male Infertility. New York, NY: WebMD. http://emedicine.medscape.com/article/436829-overview. Updated: June 7, 2016. Accessed: May 5, 2017.
  2. Anawalt BD, Page ST. Approach to the Male with Infertility. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/approach-to-the-male-with-infertility.Last updated: October 31, 2017. Accessed: December 27, 2017.
  3. Cooper TG, Noonan E, von Eckardstein S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010; 16 (3): p.231-245. doi: 10.1093/humupd/dmp048 . | Open in Read by QxMD