What Is Semen Analysis?
Semen analysis is a test of sperm and semen. Also known as a sperm count or male fertility test, its results show how many sperm are released, as well as how they're shaped and how well they move.
Semen is the thick fluid that comes from your penis when you ejaculate during sexual activity. It carries sperm out of your body so it can fertilize an egg and create an embryo (the first stage of pregnancy).
Why Have a Semen Analysis?
There are two main reasons you might have a semen analysis.
Testing for infertility
If you and your partner are having trouble getting pregnant, semen analysis is one of the first tests your doctor will likely ask for.
While both sexes can have problems, issues with male fertility can play a part in about half of all infertility cases. And male infertility is often caused by low sperm production.
Checking the success of vasectomy
Another reason you might need a semen analysis is to confirm the success of a vasectomy (a procedure to prevent pregnancy). It’s usually done 8 to 16 weeks after the surgery to see if you’re still making any healthy sperm.
How to Provide a Semen Sample
To test your semen, your doctor will ask you for a semen sample.
You’ll probably be asked to ejaculate into a collection cup in a private room at your doctor’s office. It's important to follow their instructions completely so the results will be accurate. For example, your hands and penis should be clean, and you need to collect the entire amount of fluid you ejaculate without spilling any of it.
Sometimes, you can collect your sample at home. If so, you’ll have to keep it at room temperature and get it to your doctor or lab within one hour. Some doctors provide you with a special condom that collects your semen during sex.
Don’t use lubricants when you collect your sample because they can affect how easily your sperm can move around.
How to Prepare for a Semen Analysis
Here are a few things to keep in mind before giving the sample:
- Your doctor may ask you not to have sex or masturbate for two to five days before your test to make sure your sperm count will be as high as possible.
- However, don’t hold off on ejaculating for longer than a week before your test. That can result in a sample with sperm that are less active.
- It’s best not to drink alcohol before your semen analysis.
You also should tell your doctor about any medications or herbal supplements you’re taking. Drugs that can affect your results include:
Testosterone. Supplements that boost this hormone can send the wrong signal to your body, making it stop producing natural testosterone and sperm. It can lead to a low count or lack of sperm.
Anabolic steroids. Used to build muscle, these drugs can affect your body’s sperm production.
Marijuana. The tetrahydrocannabinol (THC) in marijuana can slow down your sex drive and keep your body from making testosterone and sperm the way it should.
Opiates. These can lower your sperm count and affect testosterone production.
To get the most accurate results, your doctor will want to test more than one sample. You will need to provide another sample within two to three weeks. This is because semen samples can vary from day to day for many different reasons. You may even need to provide two to three samples over a three-month period.
At-Home Sperm Analysis Tests
There are a number of kits you can buy to test your semen without going to the doctor. Some can quickly check your sperm count at home or test their movement. Others require you to mail a semen sample for more involved tests.
If you have an abnormal result on a home test, you should follow up with your doctor. But know that a normal result doesn’t guarantee fertility. You’ll need to talk with your doctor to get a complete picture of what’s going on.
How to Interpret a Semen Analysis
Once a lab gets your semen sample, it will look at it under a microscope. This will provide a wealth of information, including:
How many sperm there are (concentration). A normal sperm count is at least 15 million sperm per milliliter of semen. A count lower than that is considered low.
How your sperm are moving (motility). Your doctor will look at how many sperm are moving and how well they move. Ideally, 50% or more of your sperm sample should be active.
What your sperm look like (morphology). The size and shape of your sperm affect how well they can fertilize an egg. Normal semen will have at least 4% normally shaped sperm.
In addition to analyzing your sperm, your doctor will also find out other details from your sample, including:
Volume. They’ll note how much semen you were able to provide for your sample. A normal amount is at least 1.5 milliliters, or about half a teaspoon. If your sample is less than that, it could mean that your seminal vesicles aren’t making enough fluid or are blocked. You could also have a problem with your prostate.
Chemical makeup. Your pH level measures the acidity of your semen. Normal pH ranges from 7.1 to 8.0. A low pH level means you have acidic semen. A high pH level means it’s alkaline. An abnormal pH can affect the health of your sperm and how well it moves.
Liquefaction time. Normal semen comes out thick during ejaculation. Liquefaction time measures how long it takes before it becomes liquid. It should take about 20 minutes. If it takes longer to liquify or doesn’t become liquid at all, it could mean there’s a problem.
If your semen analysis results are abnormal, your doctor will likely want you to have other tests to figure out your specific fertility problem.
What Do Abnormal Results Mean?
Abnormal semen analysis results could mean you have a physical problem in your reproductive tract, or that your body isn't making enough testosterone.
However, test results aren’t always a true indicator of fertility. For example, you could have a low sperm count and still be fertile, or have a high sperm count and be infertile. Talk with your doctor about what your specific numbers mean.
Several things can affect a semen analysis, including:
- Using lubricants or condoms that have lubricants in them
- Drinking alcohol
- Smoking
- Using recreational drugs
- Some prescribed medications
Results can be different depending on age, gender, and general health.
The use of in vitro fertilization (IVF) has enabled doctors to bypass the following tests, in most cases:
Sperm antibodies. This provides more information about your sperm’s ability to penetrate an egg or their swimming speed and direction. However, studies have not shown that antibodies in sperm lead to infertility.
Sperm penetration assay (SPA). Also known as a hamster egg test, this checks your sperm’s ability to break through the outer wall and fuse with the egg.
Hemizona assay test. This also tests your sperm’s ability to fuse with an egg.
Cervical mucus penetration test (Pentrak). This is done to see how well your sperm can swim through cervical mucus to get to the egg.
How Long Does a Semen Analysis Take?
You should be able to get the results of a semen analysis within a few days — possibly the same day you have the test. A home test can be completed in under an hour.
How Much Does a Semen Analysis Test Cost?
The cost of a semen analysis varies based on things like whether it's being done by an independent lab or through your doctor's office, and whether you have health insurance. You can expect to pay between $250 and $500, but check with your doctor and insurance company.
You can get a basic at-home test for less than $50, while tests you mail in for more detailed results can cost $200 and up.
Takeaways
A semen analysis is a test of semen and sperm, usually done to diagnose infertility. The analysis tells you and your doctor how much semen and sperm your body makes, and describes the shape and movement of the sperm. Many things can affect the results, so you may have to take several tests to get a clear picture of your fertility.
Semen Analysis FAQs
How can I check my sperm count at home?
You can buy a home sperm test at the drugstore or online. It can tell you whether your sperm count is low or normal. Some test kits can also test your sperm's movement. Other kinds of tests let you provide a sample at home and send it off to a lab for more detailed analysis.
Can my wife help with sperm samples?
If you have trouble getting a sperm sample on your own, it's ok to get help from your partner. But you have to be sure to keep your sample free of body fluids or lubricants. Your doctor might give you a special collection condom you can use during sex.
What to avoid before a sperm test?
You shouldn't ejaculate for two to five days before the test. Drinking alcohol, smoking, and taking recreational drugs can all affect your results.
