A sperm analysis involves checking a sample of semen for overall sperm health.The process can help doctors to determine the underlying cause of a person’s inability to conceive, or it may confirm the outcome of a vasectomy.

A semen analysis measures three major factors of sperm health:

• the number of sperm

• the shape of the sperm

• the movement of the sperm, also known as “sperm motility”

Semen analysis, also known as a sperm count test, analyzes the health and viability of a man’s sperm. Semen is the fluid containing sperm (plus other sugar and protein substances) that’s released during ejaculation.

The tests should be conducted at least seven days apart and over the course of two to three months. Sperm counts can vary on a daily basis. Taking an average of the sperm samples can give the most conclusive result.

Your doctor will let you know what you should do in preparation for the semen analysis. It’s very important to follow these instructions for accurate results.

To get the best sample :

• Avoid ejaculation for 24 to 72 hours before the test.

• Avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days before the test.

• Stop taking any herbal medications.

• Avoid any hormone medications as instructed by your healthcare provider.

Discuss any medications you’re taking with your doctor.

There are four main ways to collect a semen sample:

• masturbation

• sex with a condom

• sex with withdrawal before ejaculation

• ejaculation stimulated by electricity Masturbation is considered the preferred way to get a clean sample.

Two main factors are crucial to having a good testing sample. First, the semen must be kept at body temperature. If it gets too warm or too cold, the results will be inaccurate. Second, the semen must be delivered to the testing facility within 30 to 60 minutes of leaving the body.

A sperm analysis looks at several factors when considering the health of the sperm. We discuss these factors and their results below.

How many sperm there are (concentration) – A normal sperm count is at least 15 million sperm per milliliter of semen. Your sperm count is considered low if you have less than that.

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 their ability to 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 the following:

Volume – He will 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 in your semen. Normal pH is between 7.1 and 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 yours takes longer, or doesn’t become liquid at all, it could mean there’s a problem.

Fructose level – If your doctor doesn’t find any sperm in your semen analysis, he will probably check it for seminal fructose, which is produced by your seminal vesicles. Low levels, or no fructose, could mean you have an obstruction.

Abnormal sperm will have trouble reaching and penetrating eggs, making conception difficult. Abnormal results could indicate the following:

• infertility
• infection
• hormonal imbalance
• disease, such as diabetes
• gene defects
• exposure to radiation

If your results come back at abnormal levels, your doctor will probably suggest that you take additional tests. These tests include:

• genetic tests
• hormone testing
• urinalysis after ejaculation
• taking a tissue sample from your testicles
• anti-sperm immune cells testing

A sperm analysis is one of the first tests that males undergo to look for the reasons for difficulty with conceiving. People also require sperm analysis to check the success of a vasectomy.

If sperm analysis results are abnormal, a doctor will typically recommend further testing to help find the underlying cause and formulate a treatment plan.

Many cases of male infertility are treatable with lifestyle changes, medications, surgery, and other interventions.