A third of fertility issues are related to male factors, such as sperm quality or quantity, so it’s important to understand how we diagnose male fertility problems. Though we offer a comprehensive range of diagnostic fertility tests the first step with male fertility investigations is usually a semen analysis.
A semen analysis is one of the first tests we do when checking male fertility. It gives us a clear picture of sperm health, helping to identify any issues that might affect your ability to conceive. Whether you're starting fertility treatment or just want answers, this simple test provides important insight.
Trying to conceive can be tough if you don't know what might be causing delays. Around half of fertility issues involve male factors, and semen analysis helps us get to the bottom of it quickly. It’s an essential part of fertility investigations for individuals or couples.
We’ll ask you to provide a sample, usually through masturbation, in a private room at your local Care Fertility clinic. It’s best if you haven’t ejaculated for two to three days beforehand, this gives us the most accurate results.
If you have ejaculated less than two days ago, we may not be able to process your sample. If you’re feeling unsure or have religious or cultural concerns, let us know. We’ll do everything we can to support you.
The test looks at several factors that affect how likely sperm are to reach and fertilise an egg:
Sperm count: The number of sperm in the semen.
Motility: How well the sperm move.
Morphology: The shape and structure of the sperm.
Volume: How much semen is produced.
Other indicators: Like white blood cells or signs of infection.
Together, these results help paint a full picture of sperm health.
When we do a diagnostic semen analysis test, we undertake measurements of various factors set out by the World Health Organization (WHO), which has published reference limits for semen analysis.
The first part of the test involves measuring the volume of semen produced. The average amount is about 3ml (slightly less than a teaspoonful) and should be more than 1.5ml. The sample is then tested for its acidity (pH, normally more than 7.2) and how runny it is (viscosity). After these initial tests, the sample is examined using a microscope.
The sperm concentration, or number, is calculated using a special microscope slide with a grid. If the concentration is low (fewer than 15 million sperm per ml), it is classified as oligozoospermia, and on the rare occasions that no sperm are seen, it’s called azoospermia.
The sperm are assessed for their motility (the proportion of sperm moving) and progression (how fast they swim). Poor motility (less than 39% swimming) is called asthenozoospermia. It is also noted whether any sperm are sticking together (agglutination), as this can affect their function.
A very important part of the semen analysis is sperm morphology, which involves examining the size and shape of at least 200 individual sperm to assess whether they look normal. A normal-shaped sperm has an oval head and a tail about 10x the length of the head. It also has part of its head covered by a cap called the acrosome, which is needed to fertilise an egg. If less than 4% of sperm appear to have a normal shape, this is called teratozoospermia and can be a problem as the sperm may not be able to swim properly or attach to an egg.
A semen analysis result tells us if a man’s sample can be considered to be within the fertile range. However, it can’t tell us for sure if the sperm are actually able to fertilise eggs or not. Furthermore, it’s important to interpret a person’s semen analysis result in conjunction with their medical history.
There are further, more specialised tests which may give more information such as the Sperm Oxidative Stress (SOS) test, or testing for sperm DNA fragmentation levels. We will discuss further tests with you if we think they will be helpful.
Once your results are ready, you’ll have a consultation with a fertility specialist. They’ll review your results and explain your next steps. You’ll get a written summary, treatment options, and a cost estimate through your Care Fertility treatment companion app, Salve. If needed, we’ll also recommend any follow-up tests or investigations.
Before starting treatment, you’ll be booked in for viral screening blood tests and sent consent forms to complete using our secure online platform, Engaged MD. Once everything’s completed, you’ll meet with a nurse for your treatment planning appointment.
If you're ready to take the first step or just want some clarity, speak to our Patient Enquiry Team. They’ll help you book your test at your nearest clinic and explain what to expect.
Call us on 0800 564 2270 or click here to get in touch with our expert team.