So you’ve got your results but you don’t really understand what they mean! You’re not alone.
Getting any medical results / reports usually creates a whole lot of confusion and leads most people to “Dr Google” in an attempt to decipher the medical jargon littered throughout your report.
When it comes to a semen analysis there are really 3 main headline things we’re interested in:
- Concentration
- Motility
- Morphology
Let’s look at each in turn.
Concentration (how many sperm per ml of ejaculate)
When a man ejaculates he produces a mixture of sperm and seminal fluid (semen). The total amount of fluid is the volume of your sample. This should be between 1.5ml and 5ml.
What is then established from your sample is how many sperm are present per ml of ejaculate. This is your concentration.
The minimum figure we’re looking for here is 15million per ml.
You may also then see on your results “total sperm number” which is your concentration multiplied by your sample volume which should be greater than 39million.
Motility (how well are they moving)
Motility is a fancy way of saying “how well are they moving”. This part of the test is often broken down into several different elements. This is because sperm can be moving (but not in the right direction or just quivering), moving correctly or not moving at all. Within your results you may see the terms progressive, non-progressive and immotile. Motility is always measured as a % and we’re most interested in the motile / progressive sperm.
Progressive = moving in the right direction
Non progressive = moving but not in the right direction or going around in circles
Immotile = not moving at all
To be classed within normal range a man should have 32% or more of his sample moving in a progressive manner. You may see on some reports that this is reported slightly differently and you may seem the terms "rapid progressive" and "slow progressive".
Morphology (the shape of the sperm)
Again another fancy word that just means “the shape of the sperm”. Sperm production within the testicles doesn’t seem to be a particularly efficient process and many of a man’s sperm will be a peculiar shape. It’s not uncommon for sperm to have 2 heads, 2 tails, a short tail or no tail and all manner of other problems. This part of your result is letting you know how many of your sperm are classed as “normal” shape. What’s quite shocking if you’re not expecting it is just how few of these there will be.
To be classed within the normal range you should have 4% or higher “normal” forms.
Just to spin that around on its head, that means if you’re within “normal” range 96% of your sperm will be abnormal. and that is fine!
In summary these are the figures you should be hoping to see as a minimum.
Summary of minimum results
.png)
Medical terms
.png)
If you’re out on any 1 of these parameters it will impact your chances of conceiving naturally or through assisted treatments. If you’re out on 2 or all 3 of these parameters then your chances of conceiving will be become even less.
Other parameters
Beyond these key headline figures there are other elements that will be noted on a semen analysis that will be of more interest to a clinician but these can be missed.
Ph
The Ph of the sample is particulary important, this will indicate if the sample is acidic or alkaline. Ideally it should be sitting between 7.2 and 8.0. If the Ph is lower than 7.2 it could indicate a blockage whilst higher than 8.0 may be indicative of an infection.
Consistency / Agglutination
The consistency of your sample is also important to note. The lab will leave your sample for approximately 30mins to allow it to fully liquefy. When a man 1st ejaculates his semen can be quite sticky and gloopy but within 30mins it should fully liquefy. If this does not happen then it may be a sign of other issues that need to be investigate.
Debris
An unsual term to see on a medical report and may cause some concern however this is an important part of any semen analysis. Semen will contain sperm and other cells. Where there is an infection or other issues going on there may be a larger amount of "debris" or round cells that are beyond the normal level. If these are present then further investigations will be needed.
What’s important when having a semen analysis is to ensure your results are fully understood by the clinician requesting the test and that they are properly explained to you along with your options. If your 1st semen analysis is out of range it may be advisable to re test to confirm the result before taking any further action.
If your results remain out of range then we would always recommend ensuring you have done all you can on your lifestyle and dietary factors first. A lot can change with some very simple interventions and if you can put these in place for 3 - 6 months and retest then this will help you see what impact they might have.
However, if things are not improving or you have other causes for concern then we would recommend speaking to a clinician such a Urologist with male fertility expertise who can guide you on further tests or investigations to consider.
