Semen Analysis

Why this test may be ordered

• You and your partner have been trying to have a baby for at least 12 months without success.
• You have recently had a vasectomy and need to confirm that your semen has no sperm.

Preparation and collection

Avoid all sexual activity that results in ejaculating sperm for 2–7 days before the sample is collected. Follow your provider's specific instructions.

You will provide a semen sample by masturbating and collecting the semen in a sterile container, usually in a private room at a lab. You may also collect a sample at home using an at-home self-test kit, a self-collection kit (must be kept at room temperature and sent to a lab within one hour), or a special condom provided by your provider (must be kept at body temperature and taken to the lab within 30–60 minutes). For accurate results: urinate and wash your hands and penis before collecting; do not touch the inside of the container; do not use lubricants or saliva; collect all the semen produced; do not try to collect any semen that missed the container. Because sperm count and quality can vary, you may need to provide two or more samples within a week or two.

There is no known risk to a semen analysis.

Understanding results

Your results will include several measurements. Normal ranges are provided for reference, but your provider will interpret your results in the context of your overall health and fertility. Abnormal results do not mean you are permanently infertile; they suggest that your sperm may be contributing to difficulty getting pregnant. Your provider may order additional tests to find the cause.

• Volume: 1.5 to 7.6 milliliters: Your semen volume is within the typical range. Limitation: A volume lower than 1.5 milliliters may cause infertility. Next step: Routine
• Volume: less than 1.5 milliliters: Your semen volume is lower than the typical range, which may affect fertility. Limitation: This result alone does not confirm infertility; other factors are considered. Next step: Prompt
• Sperm count: more than 39 million sperm in the entire sample: Your total sperm count is within the typical range. Limitation: A count lower than this may make it difficult to get your partner pregnant. Next step: Routine
• Sperm count: 39 million or fewer sperm in the entire sample: Your total sperm count is lower than the typical range, which may make it difficult to get your partner pregnant. Limitation: This result alone does not confirm infertility; other factors are considered. Next step: Prompt

• Sperm count and semen quality can vary from day to day, so multiple samples may be needed.
• At-home self-test kits provide less information than a full semen analysis.
• Abnormal results do not mean you are permanently infertile; they indicate that your sperm may be part of the reason for difficulty getting pregnant.
• Your provider will interpret results in the context of your overall health and may order additional tests (e.g., ultrasounds, blood tests) to find the cause.

What to do next

If your results are not all normal, your provider may order more tests to help find the cause. Treatment for infertility depends on the cause, and your provider may refer you to a specialist. For vasectomy follow-up: if sperm is found, you will need repeat testing until your sample has no sperm, and you must continue using other birth control. If no sperm is found, you and your partner should be able to stop using other forms of birth control.

• What do my specific results mean for my fertility?
• Should I have another semen analysis to confirm the results?
• What additional tests might I need?
• What lifestyle changes could improve my sperm health?
• If I had a vasectomy, when should I have follow-up testing?

Evidence source

U.S. National Library of Medicine: Semen Analysis