How to interpret a sperm analysis
The semen analysis, also known as the seminogram or sperm study, is the first test we order for the study of male fertility at assisted reproduction clinics.
This analysis will provide us with the necessary information for detecting any issues that may be affecting fertility. Additionally, the sperm study will help us decide which assisted reproduction technique is needed, if any.
The parameters we evaluate will be compared to the parameters described by the World Health Organization. The reference values which indicate that a sperm sample is normal are those published in the latest edition of the “Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction”.
What do we study with a sperm analysis?
In a sperm analysis we will perform a complete study of the ejaculate. First, we will observe macroscopic parameters such as volume, appearance, etc. The microscopic values we will study include sperm count, motility and morphology of the spermatozoids.
When necessary, due to an abnormal result, we can request other tests. One example would be the immune study, sperm vitality test, analysis of biochemical parameters (prostate and seminal vesicle markers), and semen culture (carried out in a reference laboratory).
Macroscopic examination of the sperm study
The first thing we observe during the macroscopic examination is volume. The volume of the ejaculate should be greater than 1.5 ml as long as sexual abstinence has been around three to five days. If the volume is lower than this, then we must assume that a problem exists.
We will also analyse the pH of the ejaculate which should range between 7.2 and 8.
In addition we will study liquefaction. At room temperature, a normal semen sample will liquefy within 60 minutes of ejaculation.
The visual appearance of semen is also important. A normal sample will have a homogeneous, grey-opaque appearance. However, it may appear less opaque when sperm concentration is low.
Finally we will study viscosity, which refers to the fluidity of the sample. Just as with liquefaction, this value must be included on the report if it comes back abnormal.
Microscopic examination of the sperm study
There are also parameters to observe on the microscopic level. Let’s start by taking a look at concentration. Here we are referring to the number of spermatozoids per millilitre of semen, and values above 15 million sperm per ml of semen are considered normal.
A second value we study is motility. In a semen sample we will see different types of sperm movements: those that move forward in a straight line (type A, or progressively motile), those that are moving but whose movement is reduced (type B), and those which are totally non‑motile (type C). We consider a semen sample to be normal when the value of progressively motile sperm is equal to or greater than 32%, or when the sum of types A + B is equal to or greater than 40%.
During the microscopic examination we will also observe morphology, a parameter which measures the shape of the spermatozoid. For this category, we consider a semen sample to be normal when the number of spermatozoids without any defect is, at least, 4%.
Sperm agglutination, another factor we observe in the sperm study, refers to live spermatozoids which stick together. We must assume immunological infertility in cases where sperm agglutination occurs.
Finally, the presence of other cells such as red blood cells or white blood cells point to an infection in the semen, meaning we must keep an eye out for their presence.
Terminology of a sperm analysis
As you can see, there are several important parameters involved in a sperm study. Among the terminology that we use in assisted reproduction clinics, you will also hear us talk about the following concepts:
- Hypospermia: when the volume of the sample is less than 1.5 ml.
- Oligozoospermia: when the concentration is less than 15 million sperm per ml, or 39 million sperm per ejaculate.
- Cryptozoospermia: when the concentration of spermatozoids is very low.
- Azoospermia: where there is a total absence of spermatozoids in the ejaculate. Here you can read more about azoospermia and assisted reproduction.
- Asthenozoospermia: this term refers to sperm motility, and a male is considered to have asthenozoospermia when the number of progressively motile spermatozoids is less than 32%.
- Teratozoospermia: when the number of normal spermatozoids is less than 4%.
- Necrozoospermia: when all of the spermatozoids are classified as non‑motile.
Now you know more about the sperm study, an essential test before undergoing any assisted reproduction technique. Unless we are dealing with a serious issue, remember that you can practice healthy habits to improve male fertility, something we recommend at URE Centro Gutenberg.
Diet is also fundamental, which is why we have dedicated a whole article to this topic which we encourage you to read here: Diet and male fertility.
Do you have any additional questions? Contact us so that we can answer them for you!