Semen analysis is the main test for the assessment of male infertility, and it is important to know what your results mean (and what they don’t mean!). The most important concept to understand is that even though semen analysis provides a general sense of male fertility potential, results actually don’t have a clear and direct relationship with the odds of getting pregnant in many cases. Some men with mild or even moderately abnormal semen analysis results have totally normal fertility, while other men with perfect results struggle to get their partner pregnant. It is also important to know that semen analysis doesn’t tell you anything about the risks of having a child with a genetic or congenital problem, so there is no need to worry about that.
The main parameters analyzed in a semen analysis are ejaculate volume, pH, sperm concentration, total sperm number, sperm motility, and sperm morphology. Semen volume should be >1.5 ml.
Low volume may result from incomplete sample collection (most commonly), low testosterone, or ejaculatory problems.
Low sperm concentration (<15 million sperm/mL) or low total number of sperm (<40 million sperm in the ejaculate) are both referred to as “oligozoospermia.” Having a low sperm count is a nonspecific finding that indicates either inadequate abstinence before testing or a problem making sperm, which can be either temporary or permanent. About 1% of men have zero sperm in their ejaculate, which is called “azoospermia” and is the most severe type of male infertility.
“Asthenozoospermia” is the medical term to indicate low sperm motility (poor movement). It can either refer to less than 40% of sperm moving at all, or fewer than 32% of sperm moving with visible forward progress under a microscope. Causes of low motility include behaviors bad for sperm (like smoking or intense cycling), recent viral illnesses, varicoceles, and many other problems.
Sperm morphology is recorded as the percentage of sperm that appear “normally shaped” under the microscope. The term teratozoospermia is used when the percentage of normal-appearing sperm is lower than 4% (according to the most recent World Health Organization scoring system). Morphology is a very subjective parameter that is often abnormal, and it causes a fair amount of anxiety. Some doctors (including me!) don’t think it should even be reported because it stresses couples out and really doesn’t have a clear relationship with chances of natural or assisted conception.
If you or your partner have an abnormal semen analysis, don’t panic (especially if the abnormalities are mild). Optimize your sperm health by living a fertility-friendly lifestyle, eating right, and taking the right evidence-based male fertility supplement (like the Swimmers Antioxidant Formula). Repeat your testing after 2-3 months to give your body enough time to make a new batch of sperm. If your testing is still abnormal and your difficulty conceiving continues, see a reproductive urologist to get checked out.
