What can semen analysis results tell you?

What does the evidence say about semen analysis results?

1. Sperm concentration describes sperm per milliliter, while total count describes the whole ejaculate. Motility concerns movement, and morphology concerns shape. These measurements answer different questions, so compare a report with its own laboratory explanations instead of selecting one number as the entire result. 1
2. AUA/ASRM guidance emphasizes that semen measurements vary between samples. Results above or below a reference limit do not independently establish fertility or infertility. Repeat testing is particularly important after an abnormal result, with the timing decided by the evaluating clinician. 2
3. Collection affects interpretation. Follow the laboratory’s abstinence and transport instructions, avoid unapproved lubricants, and tell the laboratory if part of the sample was missed. An incomplete collection should be documented instead of quietly assumed to represent the entire ejaculate. 1
4. When a couple is being evaluated, assessment of both partners can proceed together. Age, ovulatory history, tubal factors and known concerns influence timing. A borderline semen result should not become a reason to postpone the rest of the evaluation indefinitely. 3
5. A fertility supplement or testosterone product is not an automatic response to a low result. AUA/ASRM guidance describes uncertain benefits for supplements and warns that testosterone monotherapy is inappropriate when current or future fertility is desired. Discuss existing prescriptions before changing them. 4

Preparing for a useful result review

• Keep the laboratory report with its units and reference ranges.
• Record collection difficulties, medicines and the requested abstinence interval.
• Ask how repeat testing and both partners’ evaluations fit into the next step.

Common semen-analysis measurements