How To Interpret A Semen Analysis Report

When trying to conceive, the male partner’s reproductive health status is equally important as that of the female. And, as a part of preconception care, it is all the more essential for men to evaluate their sperm health.¹ So, to provide insights into their sperm health, analyzing semen can be a great tool.² Doing so, will not only figure out the problem but also help them take the next step towards their parenthood journey. 

If you’ve already analyzed your semen or are planning to opt for it, you’ll come across certain parameters such as sperm concentration, sperm motility, sperm volume, sperm count, sperm morphology, sperm vitality, and much more in the report. 

So, to give you all information about these parameters included in a semen analysis report we’ve jotted down some important pointers for you in this article. Come, let’s have a look at them!

Semen Analysis Report: An Overview

A detailed semen analysis report measures the quantity and quality of semen and sperm. Semen is a white thick fluid released by men during ejaculation which contains sperm. And, sperm is a small male reproductive cell which includes the genetic material.³ 

While semen analysis is a perfect way to assess the formation and maturity of sperm as well as its interaction, it is usually recommended if: ^2,3 

• You and your partner have been trying to actively conceive for at least 12 months 
• Planning for fatherhood in the future
• Undergoing surgery or cancer treatment
• Or are curious about tracking your fertility

Next, let us understand the parameters that are analyzed!

What To Expect From The Semen Analysis Report?

The report will give information related to your current fertility status, reproductive goal status, and if there are any potential risk factors seen. Given below are a few important factors that help in evaluating sperm health: 

• Sperm Quantity - According to the World Health Organization (WHO), at least 16 million or more sperm every milliliter (ml) of semen is required in quantity⁴
• Sperm Movement - The sperms need to move, wriggle and swim. Hence, we need strong swimmers for a pregnancy to take place⁵
• Sperm Morphology - A healthy sperm typically has an oval head and strong long tail⁵

In addition to the above, the 6th edition of the “WHO Manual for the Laboratory Examination and Processing of Human Semen” provides the lower reference limits for all the semen parameters based on which analysis is usually done. Here are the numbers given by them⁴ - 

Reference Limits According To The World Health Organization (WHO) Manual For Semen Analysis

If there are any abnormalities seen in the semen parameters you might be recommended a few other tests by your doctor. They include:

• DNA Integrity Test: This test assesses the degree of sperm DNA fragmentation (defined as the breaking of one’s sperm DNA which can affect embryo quality and development) and is usually recommended to couples who have faced recurrent miscarriages, or reports indicate abnormal semen analysis results.^6,7
• Post Ejaculate Urine Sample (PEUS): This test examines the presence of sperm in the urine which can be caused by retrograde ejaculation (when semen enters the bladder) and is recommended for males with a semen volume below 1.0 ml.^6,8
• Genetic Screening: Chromosomal defects are more common in infertile men as compared to normal men, hence genetic screening and chromosomal testing might be recommended.⁶
• Hormonal Tests: It is usually advised if a low sperm count or concentration is observed. Tests such as testosterone, prolactin, serum Follicle-Stimulating Hormone (FSH), and Luteinizing Hormone (LH) might be recommended.⁶

The semen analysis report will also identify if any sperm health conditions are seen. Let us check them out in detail!

List Of Common Sperm Health Conditions Identified

1. Conditions Based On Volume And Sperm Count

• Hyperspermia - Characterised by high semen volume production.
• Hypospermia - Characterised by low semen volume production.
• Azoospermia - Characterised as the complete lack of sperm in the semen. 

2. Conditions Based On Sperm Concentration And Motility

• Oligozoospermia - A condition characterised by low sperm count in the ejaculate despite normal sexual and ejaculatory function. 
• Asthenozoospermia - Also known as asthenospermia, a condition in which sperm motility in the fresh ejaculate is decreased or absent.

3. Conditions Based On Morphology And Vitality

• Teratozoospermia - It is a condition characterised by aberrant sperm morphology.
• Macrozoospermia - It is characterized by sperm having abnormally large and deformed heads with extra chromosomes, usually four copies of each instead of the usual one.
• Necrozoospermia - It is a condition identified by the presence of dead sperm in the semen.

4. Combination Sperm Health Conditions

• Oligoteratozoospermia - Characterised by reduced sperm count and abnormal morphology.
• Oligoasthenozoospermia - Occurs where two seminal parameters are altered such as sperm count and sperm motility.
• Oligoasthenoteratozoospermia - Occurs when three of the seminal parameters are altered - sperm morphology, sperm count and sperm motility.
• Asthenoteratozoospermia - Characterised by low morphology and poor sperm motility.

5. Other Sperm Health Conditions

• Leukospermia - It is characterised by the presence of leukocytes (white blood cells) in the semen.
• Haemospermia - It is defined by the presence of blood in the semen.