At a Glance
Why Get Tested?
To learn about the health of your reproductive organs, particularly if your partner is having trouble becoming pregnant, or after a vasectomy to determine if the operation was successful
When to Get Tested?
When you think you might have a fertility problem or after you have had a vasectomy
A semen sample collected in a sterile, wide-mouth container provided by the lab, usually collected on-site; sample must be analyzed within one hour of collection. Two separate collections on two separate days may be required when testing for fertility problems.
Test Preparation Needed?
Sexual abstience for 2-5 days before sample collection; carefully follow instructions provided
The Test Sample
What is being tested?
A semen analysis measures the quantity and quality of the fluid released during ejaculation. It evaluates both the liquid portion, called semen or seminal fluid, and the microscopic, moving cells called sperm. It is often used in the evaluation of male infertility.
Semen is a viscous, whitish liquid that contains sperm and the products from several glands. It is fairly thick at ejaculation but thins out, or liquefies, within 10 to 30 minutes. Sperm are reproductive cells in semen that have a head, midsection, and a tail and contain one copy of each chromosome (all of the male's genes). Sperm are motile, normally moving forward through the semen. Inside a woman's body, this property enables them to travel to and fuse with the female's egg, resulting in fertilization. Each semen sample is between 1.5 and 5.5mL (about one teaspoon) of fluid, containing at least 20 million sperm per mL, and varying amounts of fructose, buffers, coagulating substances, lubricants, and enzymes that are intended to support the sperm and the fertilization process.
A typical semen analysis measures:
- Volume of semen
- Consistency (thickness) of the semen
- Sperm concentration (density)
- Total number of sperm (sperm count)
- Sperm motility (percent able to move as well as how vigorously and straight the sperm move)
- Number of normal and not normal (defective) sperm in terms of size and shape (morphology)
- Coagulation and liquefaction
- Fructose (a sugar in semen that gives energy to sperm)
- pH (acidity)
- Number of immature sperm
- Number of white blood cells (cells that indicate infection)
Additional tests may be performed if the sperm count is low, has decreased motility, abnormal morphology, or if the seminal fluid is found to be abnormal. These additional tests may help identify abnormalities such as the presence of sperm antibodies, abnormal hormone levels (testosterone, FSH, LH, prolactin), excessive number of white blood cells, and genetic tests for conditions that may affect fertility, such as Klinefelter syndrome, cystic fibrosis, or other chromosomal abnormality.
In some instances, radiologic testing using ultrasound, CAT scanning, or MRI may be employed. A biopsy of the testicle may also be needed. Sometimes a test called cryosurvival is done to see how well semen will survive for long-term storage if a couple would like to store sperm for future pregnancies.
How is the sample collected for testing?
Most laboratories require samples to be collected on-site as the semen needs to be examined within 60 minutes after ejaculation in order to maintain the quality of the specimen.
Semen is collected in a private area by self-stimulation. Some men, for religious or other reasons, might want to collect semen during the act of intercourse, using a condom. If this is the case, the health care provider should provide the condom or sheath because lubricated condoms can affect test results.
Sperm are very temperature-sensitive. If collection is done at home, the sample should be kept at body temperature (98.6oF/37oC) by keeping it next to the body during transportation. It should not be left at room temperature for an extended period of time and should not be refrigerated.
Sperm motility decreases after ejaculation; thus, timing and temperature are critical to obtaining accurate information. Poor sampling may require repeat testing.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
To give sperm a chance to replenish, abstain from ejaculating for 2 to 5 days before the sample is collected. Longer periods of abstinence may result in a greater volume of semen but decreased sperm motility. You may also be asked to avoid alcohol consumption for a few days before the test as well. Follow any instructions that are provided.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Hormone Health Network. Male Infertility. Available online at http://www.hormone.org/diseases-and-conditions/mens-health/infertility through http://www.hormone.org. Accessed September 2013.
Hormone Health Network. Infertility and Men. Available online at http://www.hormone.org/questions-and-answers/2012/infertility-and-men through http://www.hormone.org. Accessed September 2013.
MayoClinic.com. Male infertility: Causes. Available online at http://www.mayoclinic.com/health/male-infertility/DS01038/DSECTION=causes through http://www.mayoclinic.com. Accessed September 2013.
MayoClinic.com. Male infertility: Tests and diagnosis. Available online at http://www.mayoclinic.com/health/male-infertility/DS01038/DSECTION=tests%2Dand%2Ddiagnosis through http://www.mayoclinic.com. Accessed September 2013.
MedlinePlus Medical Encyclopedia. Semen analysis. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003627.htm. Accessed September 2013.
The National Infertility Association. The Semen Analysis. Available online at http://www.resolve.org/diagnosis-management/infertility-diagnosis/the-semen-analysis.html through http://www.resolve.org. Accessed September 2013.
Healthline. Semen Analysis. Available online at http://www.healthline.com/health/semen-analysis#NormalResults through http://www.healthline.com. Accessed September 2013.
WebMd. Semen Analysis. Available online at http://www.webmd.com/infertility-and-reproduction/guide/semen-analysis through http://www.webmd.com. Accessed September 2013.
MayoClinic.com. Is a home sperm test useful? Available online at http://www.mayoclinic.com/health/home-sperm-test/AN02181 through http://www.mayoclinic.com. Accessed September 2013.
Turek PJ. Chapter 44. Male Infertility. In: Tanagho EA, McAninch JW, eds. Smith's General Urology. 17th ed. New York: McGraw-Hill; 2008. Available online at http://www.accesssurgery.com/content.aspx?aID=3131816 through http://www.accesssurgery.com. Accessed September 25, 2013.
Borawski D, Bluth MH. Reproductive function and pregnancy, in Henry's Clinical Diagnosis and Management by Laboratory Methods, 22nd ed. McPherson RA, Pincus MR, eds. Elsevier Sanders:Philadelphia. Pp 406-408, 2011.
Laboratory evaluation of male infertility, Chapter 21, in Campbell-Walsh Urology, 10th ed. Wein AJ, Kavoussi LR, Partin AW, Peters CA, Novick AC. Elsevier Saunders, 2011.
Sources Used in Previous Reviews
Clinical Guide to Laboratory Tests (third edition), Norbert W. Tietz, editor. Philadelphia: W.B. Saunders & Co., 1995; Pp. 554-556.
Laboratory Tests & Diagnostic Procedures with Nursing Diagnoses (4th edition), Corbett, JV. Stamford, Conn.: Appleton & Lang, 1996. Pp. 727-728.
Robert Harr, M.S. MT(ASCP). Associate Professor and Chair, Department of Public and Allied Health; Program Director, Medical Technology, Bowling Green State University.
Larry J. Kricka, PhD. American Association for Clinical Chemistry, past President. University of Pennsylvania Medical Center, Philadelphia, PA.
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 843-845.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 978-979.
Dugdale III, D. (Updated 2008 May 21). Semen Analysis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003627.htm. Accessed February 2010.
Rubenstein, J. and Brannigan, R (Updated 2008 March 26). Infertility, Male. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/436829-overview through http://emedicine.medscape.com. Accessed February 2010.
Bayrak-Toydemir, P. et. al. (Updated 2009 August) Infertility. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Infertility.html# through http://www.arupconsult.com. Accessed February 2010.
Rebar, R. (Revised 2008 November) Infertility, Sperm Disorders. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec18/ch256/ch256b.html?qt=semen analysis&alt=sh through http://www.merck.com. Accessed February 2010.