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Fertility Health
Learn more about male fertility and what to expect if you’re scheduled for a semen analysis.

Starting a family isn’t always easy, and fertility isn’t just a concern for women. If you’ve been trying to conceive for a year without success, it might be time to seek fertility advice. Your healthcare provider may suggest a semen analysis – and as with any medical procedure or test, you may have several questions. What is a semen analysis? Why do you need one? What happens if your results aren’t normal?  

Read on to learn more about male fertility and what to expect if you’re scheduled for a semen analysis.  

Why do you need a semen analysis? 

One out of every eight couples has trouble conceiving. One-third of the time, it turns out there’s a problem with the man. One-third of the time there’s a problem with the woman. And one-third of the time, there are problems with both the man AND the woman. 

Keep in mind, a couple without fertility concerns having regular sex without birth control has about a 1 in 5 chance of conceiving each month. So, it isn’t unusual for it to take 6 months or longer to conceive naturally. 

Most couples should try on their own for a full year before consulting a doctor. However, if the woman is in her late thirties or beyond, it’s probably best to speak to a doctor after 6 months of trying. 

In most couples having trouble conceiving, the first conversation is usually with the woman’s gynecologist (GYN). The GYN will usually ask the woman some basic questions ( e.g. “Are you getting your period regularly?”) and will usually send the male partner to get a semen analysis. 

What is a semen analysis? 

Most men aren’t thrilled at the prospect of undergoing a semen analysis. But, it’s a simple place to start to help evaluate your fertility.  

So – what is a semen analysis? A semen analysis is a test that examines your semen under a microscope to evaluate your sperm health. It reveals important information about your sperm count, morphology (shape), and motility.   

How do you prepare for a semen analysis 

It’s best to work with a lab that specializes in semen analysis to make sure you get accurate results. Labs that are part of a fertility clinic are great, reliable options.  

In preparation for your semen analysis, your doctor will usually advise you to avoid ejaculation for 24-72 hours prior to the test, and may also recommend that you stop certain medications, along with alcohol, caffeine, and drugs for a period of time before your analysis.  

On the day of your semen analysis, you’ll need to provide a semen sample so your healthcare provider can conduct the test. Most of the time, you’ll collect a semen sample in a private room of the fertility clinic, but there are a few other options. Talk to your healthcare provider to find out what would work best for you.  

Sperm health and semen quality can vary from day to day, so your healthcare provider may conduct 2-3 separate semen analyses over the course of a few weeks (or even months) to get a good idea of your sperm health.  

What are normal semen analysis results? 

Healthy semen analysis results can look a little different for every man. First – remember that semen is comprised of seminal fluid plus sperm. The seminal fluid is the “carrier fluid” and makes up about 98% of the ejaculate by volume. Sperm is the male reproductive cell that fertilizes the egg. Sperm cells make up only 2% of the volume. 

What does your doctor evaluate when they do a semen analysis? Well, there are 3 important criteria that they focus on. 

1. Sperm count

Sperm count refers to how many sperm are present in the ejaculated specimen. Healthy sperm count ranges from 15 million sperm to 200 million sperm per milliliter of ejaculate.

2. Sperm motility  

Sperm cells have to take a long journey to reach the egg and fertilize it, so they need to be able to move efficiently. Sperm motility refers to how well sperm can move. Typically, at least 40% of sperm should be motile.   

3. Sperm morphology 

Sperm morphology refers to the shape of sperm. A perfectly shaped sperm has an oval head and a long tail. But many sperm are shaped a little differently – their head may be too large or misshapen, their tail may be crooked, or they may even have two tails. According to the World Health Organization (WHO), at least 4% of sperm should display healthy morphology to support fertility. So even though the majority of sperm may not be perfectly shaped, you still have a chance to conceive naturally.  

What if my semen analysis results are abnormal? 

What happens next if the semen analysis results aren’t perfect? Well, that depends. 

First, keep in mind that if there are slight abnormalities in one or more of the parameters (count, motility, and/or morphology), that doesn’t mean that natural conception is impossible. It may just take a little longer. There are several things you can do to improve the health of your sperm. Aside from diet and lifestyle changes, certain nutritional supplements may help support healthy male fertility.  

But if there are significant abnormalities on the semen analysis results, you should consider scheduling an appointment with a urologist who specializes in male fertility to help determine your best course of action.  


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