Semen Analysis

Semen analysis is a key test in the assessment of male fertility. It is performed with clear instructions, appropriate discretion, and in a calm environment, while the results help us determine the most appropriate next steps.

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A Comprehensive View of Male Reproductive Health

What Is a Semen Analysis?

Semen analysis is a laboratory examination of seminal fluid and the sperm cells it contains. It provides information about their number, motility, viability, morphology, as well as other characteristics of the ejaculate. The examination can help us identify abnormalities, but it does not establish the final diagnosis on its own.

Macroscopic Assessment

We assess semen volume, appearance, pH, viscosity, and liquefaction time. These parameters provide information about the function of the prostate, seminal vesicles, and other structures involved in the formation of seminal fluid.

Microscopic Assessment

Under the microscope, we assess sperm concentration and total sperm count, motility, viability, and morphology. When necessary, we also evaluate the presence of agglutination, round cells, and leukocytes.

Each Parameter Reveals a Different Part of the Picture

What Does Semen Analysis Assess?

Semen volume reflects the total amount of seminal fluid, while pH provides information about the balance between secretions from the prostate and seminal vesicles. The lower reference limit for semen volume is 1.4 mL. A lower value may be associated with incomplete sample collection, a short period of abstinence, or a medical cause requiring further assessment.
After ejaculation, semen initially has a thicker consistency and gradually liquefies. Delayed liquefaction or increased viscosity may make the assessment and movement of sperm more difficult, but these findings do not establish a diagnosis on their own.
Sperm concentration indicates the number of sperm cells in one millilitre of semen, while the total sperm count represents all sperm cells in the entire ejaculate. The lower reference limits are 16 million per millilitre and 39 million per ejaculate. The total sperm count often provides a more complete picture than concentration alone.
We assess what percentage of sperm cells are moving and whether their movement is progressive. The lower reference limits are 42% for total motility and 30% for progressive motility. Results may be affected by the time between sample collection and analysis, temperature, illness, and the way the sample was collected.
Sperm vitality indicates the percentage of sperm cells that are alive. It is assessed mainly when motility is markedly reduced, helping us distinguish immotile but living sperm from non-viable sperm. The lower reference limit is 54%.
Morphology assesses the shape of the sperm head, midpiece, and tail according to strict criteria. The lower reference limit is 4% normal forms. This value does not mean that all remaining sperm cells are necessarily genetically abnormal or that natural conception is impossible.
Agglutination refers to the clumping of motile sperm cells. Round cells may represent immature germ cells or leukocytes and, when present in increased numbers, can be differentiated through additional analysis. The presence of leukocytes may suggest inflammation but does not automatically confirm an infection.

From Preparation to Interpreting the Results

How Is the Test Performed?

Reliability of Laboratory Analysis

Why Does Standardised Analysis Matter?

Semen analysis is sensitive to both time and testing conditions. In our andrology laboratory, samples are processed according to a standardised protocol. We follow current World Health Organization recommendations and apply internal quality control and expert microscopic assessment.

Automated systems can support the analysis, but they do not replace the experience of the specialist or medical interpretation.

How Is a Semen Analysis Interpreted?

Reference Values Are Not a Diagnosis

The WHO lower reference limits are statistical reference points, not an absolute boundary between fertility and infertility. A value below these limits does not mean that conception is impossible, just as a result above them does not guarantee pregnancy.

Terms such as oligozoospermia, asthenozoospermia, and teratozoospermia describe abnormalities in sperm concentration, motility, and morphology respectively. The findings are interpreted together with the other semen parameters and, when indicated, additional assessment of the sample.

These terms describe the semen analysis findings, but they do not identify the underlying cause.

Questions

Frequently Asked Questions

A period of two to seven days without ejaculation is recommended, together with following the laboratory’s preparation instructions. Please tell us about any recent high fever, illness, or medications you are taking. Do not stop prescribed treatment without consulting your doctor.
This is possible only after prior consultation with the laboratory. The sample must be transported in the sterile container provided, protected from significant temperature changes, and delivered within the specified timeframe.
If these conditions cannot be met, we recommend collecting the sample at the clinic.
Please let us know. This is common and there is no reason to feel uncomfortable. We can discuss allowing more time or finding a quieter or more suitable alternative place for sample collection.
Do not use standard condoms or lubricants unless specifically instructed by the laboratory.
Please inform the laboratory approximately which part of the sample was lost. The first fraction usually contains a higher concentration of sperm, so losing it may significantly affect the result.
Depending on the circumstances, we may recommend providing a new sample.
A single result within the reference ranges may be sufficient for an initial assessment. If abnormalities are identified, the sample is incomplete, or there is a factor that may temporarily affect the parameters, a repeat test is usually recommended.
No. A single parameter below the reference limit does not establish infertility. The severity and combination of abnormalities, repeat test results, medical history, and the reproductive health of the female partner all need to be considered.
Sperm morphology is assessed according to very strict criteria. A result of 4% normal forms does not mean that the remaining 96% of sperm cells are genetically abnormal or completely unable to fertilise an egg.
Morphology is interpreted together with sperm concentration, motility, and the other semen analysis results.
Semen analysis assesses the main characteristics of the ejaculate and sperm cells. A semen culture tests for microorganisms when an infection is suspected.
Sperm DNA fragmentation testing assesses the integrity of the genetic material within sperm cells and is recommended only for specific medical indications.

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