Semen Analysis

A semen analysis measures the amount of semen a man produces and determines the number and quality of sperm in the semen sample. A semen analysis is usually one of the first tests done to help determine whether a man has infertility problems. Problems with the semen or sperm affects more than one-third of infertile couples. 

Tests that may be done during a semen analysis include:

• Volume. This is a measure of how much semen is present in one ejaculation.
• Liquefaction time. Semen is a thick gel at the time of ejaculation and normally becomes liquid within 20 minutes after ejaculation. Liquefaction time is a measure of the time it takes for the semen to liquefy.
• Sperm count. This is a count of the number of sperm present per milliliter of semen in one ejaculation.
• Sperm morphology. This is a measure of the percentage of sperm that have a normal shape.
• Sperm motility. This is a measure of the percentage of sperm that can move forward normally. The number of sperm that show normal forward movement in a certain amount of semen can also be measured (motile density).
• pH. This is a measure of the acidity (low pH) or alkalinity (high pH) of the semen.
• White blood cell count. White blood cells are not normally present in semen. 
• Fructose level. This is a measure of the amount of a sugar called fructose in the semen. The fructose provides energy for the sperm.

Why perform a semen analysis

A semen analysis is done to determine whether:

• A man has a reproductive problem that is causing infertility
• A vasectomy has been successful
• The reversal of a vasectomy has been successful

How to Prepare

You will be asked to avoid any sexual activity that results in ejaculation for 2 to 4 days before a semen analysis. This helps ensure that your sperm count will be at its highest, and it improves the reliability of the test. If possible, do not avoid sexual activity for more than 1 to 2 weeks before this test, because a long period of sexual inactivity can result in less active sperm. It is also best to avoid drinking alcohol for a few days before the test. 

Requirements regarding semen analysis

• A 2 – 4 day’s period of sexual abstinence before performing the semen analysis is important. 
• Semen should ideally be produced by masturbation. Condoms are toxic to sperm and coitus interrupts may lead to contamination by vaginal germs. 
• The semen must be collected in a sterile pathology laboratory bottle. 
• The specimen should be produced at the laboratory or should be brought to the laboratory for analysis within 30 minutes if produced elsewhere. 

Information regarding the semen analysis: 

It takes about 10 – 12 weeks from the initiation of new sperm formation for fully mature sperm to appear in the ejaculate. During this period sperm are very easily adversely affected by conditions such as stress, fever, hard work and minor health disturbances.

Your doctor must therefore consider any significant events in your history as far back as three months before the semen analysis.

Most experts recommend that men undergoing infertility evaluation have three separate analyses performed with at least 4 weeks in between analyses.

If a meaningful problem persists your doctor will probably refer you to an “urologist” or an infertility clinic for further evaluation and treatment.