Semen Analysis – Diagnosing Male Infertility – Low Sperm Counts

The semen analysis is one of the most important tests for infertility. A male factor is found in nearly half of all couples with infertility. Even men who have had children in the past can develop fertility problems that are only detected by semen analysis.

To perform a semen analysis, you should abstain from sexual activity for at least 2 days, but not more than 7 days. For most men, 3 or 4 days abstinence is best. You collect the sample by masturbation into a sterile container; it is important not to lose any of the specimen. You may perform the semen analysis at either of our offices (Olathe or North Kansas City). If you live close, you may collect the sample at home and bring it to us, as long as it is within 60 minutes of collection. You will be asked to show a photo ID for identification.

The semen analysis provides much more information than just a sperm count. The volume of the sperm sample as well as their activity are important in determining the total number of motile sperm. Other aspects include the shape of the sperm, how quickly it liquefies, and if there any signs of infection.
Here are the parts of the semen analysis:

• Concentration – often referred to as a sperm count, it is the number of sperm present in each milliliter of fluid (a teaspoon holds 5 milliliters). A normal concentration is 20 million per milliliter.
• Motility – this is the percentage of sperm with movement. At least 50% of the sperm should be motile. This is further broken down into those with progression (moving forward) versus those that are not; at least 50% of all sperm should have forward progression.
• Volume – total amount of fluid collected in the sperm sample. A normal volume is at least 1.5 milliliters but not more than 5 milliliters.
• Total motile count – this is the total number of moving sperm in the sample. To get this number, you multiply the volume by the concentration, and again by the percent that are motile. Usually there are at least 15 million motile sperm in the sample.
• Morphology – this refers to the shape of the sperm. Surprisingly, abnormally shaped sperm are common. Many labs use the World Health Organization criteria for grading the shape of the sperm, which considers a sample normal if at least 30% of the sperm have a normal shape. Midwest Reproductive Center uses a much stricter grading system in which the different parts of the sperm are measured. By this grading system, a sample is normal if more than 4% of the sperm have normal measurements.
• Viscosity – or thickness of the sperm fluid. Low or moderate viscosity is considered normal.
• Leukocytes – these are white blood cells, which are signs of inflammation or infection. A small number of leukocytes can be normal, while more than one million leukocytes per milliliter is considered abnormal.

Semen Sample Collection Instructions