What is semen analysis?
Semen analysis is when freshly ejaculated semen is tested in a laboratory, and the number, shape and movement of sperm are measured under a microscope. This analysis is an important part of diagnosing male infertility.
The quality of your semen can change between samples. Even if you’re completely fertile, sometimes illness, fevers and infections can lower your sperm quality for up to several months.
That’s why a minimum of two semen analyses, at least six weeks apart, are needed to properly check fertility.
Find out more about male infertility.
What is checked in a semen analysis?
A semen analysis will check for a number of things, including:
Semen volume (the amount that you ejaculate)
Sperm concentration (also known as sperm count, meaning the number of sperm per millilitre of semen)
Total sperm number
Sperm motility (the number of moving sperm compared to non-moving sperm)
Sperm vitality (the number of ‘alive’ sperm)
The number of ideally shaped sperm (normal sperm) compared to oddly shaped sperm (abnormal sperm)
White blood cells (which can be a sign of infection)
Semen pH (to see if you’re semen is acidic or alkaline; it should be slightly alkaline)
Sperm antibodies (a protein that fights sperm).
How is semen collected for testing?
Semen testing should be done with a fresh semen sample ejaculated within one hour of examination. A semen sample is best collected in a specimen jar and produced by masturbation. You usually do this in a private room at the testing laboratory. When you collect semen at home, you have to keep the sample warm and take it to the laboratory very quickly – within one hour if possible. If this method of collecting semen is too difficult, you can talk to your doctor about alternatives.
You need to make sure that you don’t lose any of the semen sample. As sperm are mostly in the first part of the ejaculate, losing the first part can falsely lower the sperm concentration. It’s important that you don’t ejaculate for at least two days before the sample is collected, but it’s equally important that it’s not been longer than seven days since you last ejaculated.
Do I need a referral from a doctor to have a semen analysis?
Your doctor can give you a referral to have a semen analysis at a pathology laboratory, which is often covered by Medicare. More specialised laboratories, such as those that run in vitro fertilisation (IVF) programs, perform more extensive testing. You should ask about out-of-pocket costs for semen analysis when you contact the laboratory.
What do the results of a semen analysis mean?
A semen analysis doesn’t guarantee that you’re fertile, because there can be other reasons for infertility.
If you have a very low sperm concentration, you might still be able to get pregnant naturally.
Many factors can affect a couple’s chance of getting pregnant, including the couple’s frequency and timing of sex, the length of time the couple has tried to get pregnant, and the age and fertility of the female partner. Your semen analysis needs to be looked at together with other clinical information by your doctor.
Are other tests done as part of a semen analysis?
In some cases, you might need to provide a urine sample after ejaculation if your doctor thinks you have retrograde ejaculation (ejaculation back into the bladder). They’ll then check your urine for sperm.
If the results aren’t what you had hoped, this can be an upsetting experience. Reaching out to psychologists and counsellors, as well as family, partners, and friends for support can help.