Semen Analysis Interpretation

How do I interpret a Semen Analysis?

One of the first tests a urologist orders is a semen analysis because sperm abnormalities are very common. How the results are interpreted can vary from lab to lab, because there are many methods for evaluating sperm. Abnormal findings, then, should be confirmed with a repeat semen analysis. Men with abnormal findings should be evaluated for genital tract anomalies as well as hormonal abnormalities. Most men with an abnormal semen analysis can father children with appropriate treatment.

Volume: What was the volume of ejaculate produced?
Human semen is produced in relatively small amounts. While a normal range for volume is provided, there are no known causes of infertility associated with abnormal semen volume. Too little or too much semen, however, may interfere with proper delivery of the semen to the female during intercourse. Most frequently, a small volume of semen indicates an incomplete collection or an obstruction within one or more ducts that contribute fluid to semen.

Count: How many sperm per milliliter were produced?
The sperm count is given in total count and concentration (sperm/ml). Low sperm counts are usually assumed to be related to infertility. This is not perfect, as there are men with low counts who have children. Low sperm counts can be due to anatomical or hormonal issues, but many go unexplained.

Motility: How many moving sperm are present?
Some labs will “rate” the quality of the motility by a grading system. This can be subjective. An important value is the percent of sperm with forward, or progressive, motility. Possible causes of low motility include varicoceles, infection, and sperm antibodies. Of note, some men with high counts and lower motility may still have normal amounts of moving sperm.

Morphology: What percentage of sperm are normally shaped?
Morphologically normal sperm have the best chance of fertilizing an oocyte, immature egg cell.  A morphology evaluation is an important step in IVF (in vitro fertilization) and/or ICSI (intra-cytoplasmic sperm injection) preparation. This evaluation may detect the presence of abnormal morphology in an ejaculated semen specimen; however, this may not reflect an abnormality in fertility, especially if the total sperm count is normal AND only a small percentage of the sperm are abnormally shaped.

Definitions of Semen Abnormalities

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