How to read a semen analysis

  Often a semen analysis is performed at the onset of that evaluation. A semen analysis, also known as a sperm count or spermogram, is a laboratory test that evaluates various parameters of semen to assess a man's fertility. Here are some of the key parameters measured in a semen analysis and what they signify:

 Significance: The number of sperm per milliliter of semen. 

   Significance: The total number of sperm in the entire ejaculate.

Significance: Measures the amount of semen produced in one ejaculation.

Normal Range: Normal semen volume is usually between 1.5 to 6 milliliters. Below 1.0 milliliters is abnormal.

Significance: Evaluates the percentage of sperm that are actively swimming and their ability to move forward.

Significance: This is the single most important factor in determining a man’s fertility. 

It is a calculated number, taken from total sperm count (which is concentration x volume) x motility.  So for example, if your semen analysis shows a sperm concentration of 30 million/ml, and a volume of 2 ml, your total count would be 30x2=60 million sperm. You then take this number, which sometimes is already given, and multiply by motility as a percentage. In the above example, if your total count is 60 million, and motility is 50%, 60x0.5 = 30 million as a total motile count.

Sometimes the total motile count is already given in a semen analysis, sometimes abbreviated as TMC.

Ideally this number is above 50 million, 20-50 million is still within a normal range but       decreased probability, 10-20 million is on the very low end of the normal range and has an even more decreased probability, and below 10 million is unlikely to lead to natural pregnancy.

Significance: Assesses the percentage of sperm with a normal shape, as abnormalities can affect fertility but most often times do not. More important than the actual number is the distribution. More specifically, it is more important to assess why a morphology is low rather than the number itself.

Normal Range: Typically, a minimum of 4% normal-shaped sperm is       considered normal.

Significance: Evaluates the acidity or alkalinity of the semen.

Normal Range: Normal pH levels in semen typically range from 7.2 to 7.8.

Significance: Measures how quickly the semen changes from a gel-like consistency to a more liquid form, which is essential for sperm mobility.

Normal Range: Normally, semen should become liquid within 20-30 minutes after ejaculation.

Significance: Detects the presence of immune cells in semen, which may indicate infection or inflammation.

Normal Range: Ideally, there should be very few or no white blood cells in the semen.

Significance: Measures the presence of fructose, which is produced by the seminal vesicles and provides energy for sperm.

Normal Range: The presence of fructose is typically normal in semen.

Significance: Assesses the thickness or stickiness of semen, which can affect sperm mobility.

Normal Range: Normal semen should not be excessively thick or sticky.