Semen Analysis

Semen analysis is a simple test that can help to identify some of the common causes of male infertility. It’s important to have these fertility checks as the results can tell us which type of fertility treatment is right for you. For example, if a male fertility problem is detected during semen analysis then your doctor may recommend using the ICSI procedure to increase the chances of fertilisation during IVF treatment.

What is Semen Analysis?

Semen analysis is a lab test that can check the health of the sperm cells that are present in a man’s semen. The sperm are the cells that fuse with the egg during fertilisation. Semen is the name for the fluid that is ejaculated, which includes various proteins and sugars as well as the sperm cells.

You might also hear semen analysis being referred to as a sperm count test, but the analysis will look at more than just the number of sperm cells that are present. The test will check for a number of different issues that could affect your ability to conceive naturally or with IVF.

The main part of the test involves looking at the sperm cells under a microscope. The semen or fluid surrounding the sperm cells will also be checked for issues such as abnormal pH that could affect your fertility. You might need to have several sperm analyses in order to get a better understanding of the variability in your sperm count and health. The results can also reveal whether any lifestyle changes you’ve made to improve your fertility have had an effect.

Why Undergo Semen Analysis?

A semen analysis is the main test that can be used to assess male fertility. You might have this test if you are concerned about your fertility, you’ve been trying for a while, or you’re considering fertility treatment. The results may help us to identify the cause of male fertility problems when they are linked to issues such as a low sperm count, poor mobility or abnormal sperm shapes. If we can identify a specific reason for your fertility problems, then it can help us to choose the best approach to treatment. For example, if the semen analysis suggests that your sperm have very low motility, we might suggest ICSI to increase the chances of successful fertilisation during IVF treatment.

How to Prepare for Semen Analysis?

Preparation is important before you have a semen analysis as it can have a big effect on the results. You should make sure that you follow your doctor’s instructions carefully before you go to the clinic to provide the semen sample. You will usually be told to:

  • Avoid ejaculating for about 24 to 72 hours before you provide the semen sample
  • Not drink and alcohol or caffeine for 2 to 5 days before you have the test
  • Not use any recreational drugs
  • Stop taking herbal remedies such as St. John’s wort

You may also be advised to stop taking certain medications such as hormonal therapies, but it is important to check this with your doctor before making any changes.

How is Semen Analysis Conducted?

Semen analysis is a relatively straightforward investigation that simply requires you to provide a sample of your semen. It’s important for the sample to be as fresh as possible, so you will usually be asked to provide it at the clinic. The sample can then be sent straight to the lab to check:

  • The volume or amount of semen in the sample
  • The total number of sperm in the sample
  • The concentration of the sperm cells (the number in each millilitre of semen)
  • How many of the sperm cells are alive
  • How well the sperm are moving (motility)
  • Whether the sperm cells look normal or have abnormal shapes (morphology)
  • If the semen is at the right pH

The results of semen analysis will be most accurate when the test is performed within 60 minutes of the sample being collected. It is also essential for the semen sample to be kept at the right temperature until the test has been completed.


You should receive a full report on your semen analysis within a few days. The results will cover many different aspects of sperm health and fertility. It should tell you whether your results were in the normal range or not. You will be able to discuss the results with a fertility specialist, who will help you to understand what they mean for your chances of having a baby using your own sperm.

You might be surprised by the results of your sperm analysis as the numbers of healthy sperm can seem very low even for men without fertility issues. We only expect about 4% of the sperm to have a normal shape and at least 40% to be moving in normal semen. The typical sample has so many sperm cells in it that it only takes a small proportion of them to be capable of reaching and fertilising an egg.

If your results do reveal a problem, such as a low sperm count or lower than normal motility, then it may be possible to overcome these with IVF treatment, ICSI, or surgical extraction of the sperm from your testes. In some cases, abnormal results during semen analysis can indicate another issue that it may be possible to treat to improve your fertility. For example, some infections can affect the health of your sperm. Treating these infections with antibiotics can improve your chances of having a baby.

How Can We Help?

Fertility tests are an important first step when considering fertility treatments like IVF. We can ensure that you get the right kind of tests so that you can select the best approach for you. Our fertility specialists can also help you to understand your semen analysis results and advise you on your options.

If you’re worried about male infertility then get in touch to learn more about semen analysis or to arrange your fertility check-up. We can arrange all the tests you need if you’re considering IVF abroad or in the UK.

Semen Analysis FAQs

Semen analysis is usually recommended for any man who is having fertility problems. The test can identify some of the most common causes of male infertility, including low sperm count and poor motility. The results will determine whether it is possible to perform IVF or if the ICSI procedure is needed to ensure fertilisation during IVF treatment.

The sperm count is the number of sperm cells that are present in the sample. It is usually given as the number of sperm cells per millilitre of semen. A normal sperm count should be over 20 million cells, but it can be much higher. Some men have sperm counts of over 200 million, but this isn’t the only factor that determines whether they are fertile.

The total amount of volume of semen that is produced can affect the chances of conceiving. A larger quantity of semen should contain more sperm cells. The fluid surrounding the sperm can also help the cells to survive. A normal semen sample should contain more than 2 millilitres of fluid. However, a larger sample isn’t always better as it might contain a lower density of sperm.

The pH level is a measure of how acidic or alkaline the semen is. A normal result will usually be between 7.2 and 7.8 as semen should be slightly alkaline. If the pH is less than 7 then it can indicate that the ejaculatory ducts are blocked. If the pH is too high it can be a sign of an infection.

Sperm cells look a bit like tiny tadpoles, with an oval head and a long tail that enables the cell to swim towards the egg. However, lots of sperm cells have an abnormal appearance. They may be misshapen or even have more than one tail. The semen analysis will check the appearance of the sperm to assess fertility. In a healthy sample, more than 50% of the sperm cells should be normally shaped. The sperm should also be a white or greyish colour. A reddish tint might indicate that blood is present in the sample while yellowish sperm could be a sign of jaundice. Further tests or treatment might be required to address these issues.

Motility is essential for sperm cells to be able to reach the egg, even when fertilisation is happening in vitro. During a semen analysis the movement of individual sperm cells is ranked on a scale of 0 to 4 by an automated program. A score of 0 means that the cell isn’t moving. Good motility is indicated by a score of 3 or 4. In a normal sample, more than half of the sperm cells should show good mobility after an hour.

If a problem is detected during the semen analysis then you will need to discuss the results with your fertility specialist. Depending on the findings, it may be possible to use techniques such as IVF and ICSI to enable you to have a baby using your own sperm. However, if this is not possible you may want to consider using a sperm donor in order to have a baby. If the results were at the lower end of the normal range, your doctor may also suggest some lifestyle changes that you can make to improve your sperm count or the health of your sperm.

Your lifestyle can have a big impact on the health of the sperm that you are producing, so it can also affect your chances of conceiving naturally or with IVF. If you are trying to have a baby then it is a good idea to ensure your lifestyle is as healthy as possible. You should eat a healthy, balanced diet and take regular exercise. It can be helpful to lose any excess weight. You should also avoid smoking, drinking alcohol and caffeine. Overheating the testicles can also affect sperm so you should wear loose underwear and clothing.

It is estimated that about 15% of couples will be unable to get pregnant after trying to conceive naturally for a year. In about half of these couples, the problem is linked to male infertility, which is often due to issues with the sperm quantity or health. Fertility problems are just as common for men as they are for women and they affect large numbers of men, especially in later life. Many of these men will still be able to conceive their own children with treatments such as IVF and ICSI that can help the sperm to reach the egg. However, about 10% of men with fertility problems aren’t able to produce sperm and therefore will need to use a donor if they want to have a baby.

Semen analysis is a completely safe and non-invasive test as long as you are able to provide a semen sample through ejaculation. However, in some cases you may need to have sperm cells extracted directly from the testes if there aren’t enough cells present in your semen. This isn’t usually necessary and it is a fairly straightforward procedure that is unlikely to cause any complications.

It is important for both the male and female partners to have a full fertility assessment if you are having trouble conceiving naturally. Understanding why you are having problems will enable your fertility expert to provide the right care for you. One or both of you may be affected by fertility problems that can be overcome with IVF or other treatments.

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