Semen Analysis: Procedure & Results

As studies have revealed, %7 of men in the world are suffering from fertility problems. The most crucial factor in fertility treatments is diagnosing the cause of the problem; so, at the beginning of the treatment, your urologist will do physical examinations and ask you to take lab tests.

A Spermogram test or semen analysis is one of the most reliable and accurate lab tests that give you and your doctor a lot of information about the quantity and quality of your semen and sperm. Sperm analysis is also an effective method of finding male infertility causes. You may be asked to take this test three or four times in seven days.

What Is Semen Analysis? 

Semen analysis is an important fertility test through which the sperm’s count, shape, size, and motility are evaluated. Also, in a spermogram, factors such as the volume of the semen, liquefaction of the semen, number of white blood cells, and pH of the semen are measured. 

Semen Analysis Procedure

During the semen analysis, which is usually performed in a laboratory, you have to masturbate in a sterile cup provided by the laboratory. The patient should use no oil, lubricant, or even saliva during the ejaculation as it affects the accuracy of the sperm analysis results. 

Sometimes, when the patient cannot ejaculate solely, the doctor asks him to have sexual intercourse with his partner and take the semen sample to the laboratory within 30 to 60 minutes. This way, the patient can use a lubricant-free condom or remove his penis from the vagina before ejaculation to provide the sample. It is noteworthy that during the transfer of the sample to the library, it should not be exposed to sunlight or heated or cooled.

How to Prepare for Semen Analysis?

Although the spermogram test is simple, you must consider the following tips before the test.

• Avoid ejaculation for 2 to 5 days before the test;
• Avoid drinking alcohol;
• Stop smoking for at least one week before the test;
• Inform your doctor about the meds you are taking;
• Avoid using herbal supplements before the test;
• Avoid taking a hot shower or going to the sauna the night before the test, and
• Do not drink caffeine beverages, specifically energy drinks. 

Semen Analysis Results

Depending on the factors to be analyzed, the lab will hand in the semen analysis results within 24 to 72 hours. Several factors to consider in a spermogram include sperm count, sperm motility, sperm morphology, pH and volume of the semen, etc. In the following, we discuss each parameter in detail:

Sperm count

One of the main factors to be analyzed in semen analysis is sperm count (sperm count test). Usually, there should be 15 to 200 million sperm in each ejaculation; if there are less than 15 million sperm in your semen, your chance of getting your partner pregnant decreases. Low sperm count can occur in men with testosterone deficiency or congenital bilateral absence of vas deferens (CBAVD).

Sperm morphology

Sperm morphology indicates what percent of sperm have a standard shape in a sperm analysis. If this percentage is more than 5%, you have healthy sperm that can fertilize an egg. 

Sperm motility

More than 50% of the sperms should have normal motility within an hour after ejaculation. Sperms generally have four types of movement, which can be classified as:

• Grade A: these are progressive and fertile sperms, which should be at least 16%.
• Grade B: these are slow progressive but relatively good sperms, which should be at least 16%.
• Grade C: these are poor and non-progressive sperms that can move their tails but cannot swim forward. 
• Grade D: these are immotile sperms.

Read more: Low Sperm Motility: Tips for Getting Pregnant

Semen PH level

The pH level of the semen should be between 7.2 and 7.8. A pH level above 8.0 can indicate that the sperm donor is infected. A less than 7.0 may indicate that the sample is contaminated or that the male ejaculatory ducts are blocked.

Read more: Treatment for Low Sperm Count.

Semen volume

A standard semen sample should have a volume of 2 to 5 cc. Low semen volume may indicate retrograde ejaculation (semen enters the bladder instead of exiting the penis during orgasm) or hormonal imbalance. On the other hand, too much semen can also mean that the semen is watery and low quality.

Sperm concentration

Usually, semen is concentrated and thick, but it turns into a watery liquid 15 to 30 minutes after ejaculation. The male reproductive system is probably problematic if the semen loses its concentration in less than 15 or 30 minutes. Sperms generally have a lower count but higher motility in watery semen.

Semen appearance

Semen usually is white or grey. The semen can also become yellow by taking some drugs or vitamins and brown due to the presence of blood in the semen.

Amount of fructose in semen

The low level of fructose in semen indicates the improper function of the seminal glands.

Read more: Azoospermia Treatments (Obstructive & Non-obstructive)

Reasons for Semen Analysis

Sperm analysis is often done for three reasons:

To find the cause of male infertility

If the cause of infertility in a couple is the male partner, the doctor takes a spermogram to check the quality, number, shape, and motility of his sperm.

To determine whether the vasectomy was successful

after the vasectomy surgery, the patient should take a semen analysis to ensure that the operation was successful and there is no sperm in the semen.

Sperm test for the diagnosis of azoospermia

If you have been trying to conceive for a long time but failed, your doctor will ask you to take a spermogram (sperm analysis). If there is no sperm in your semen samples -at least two samples taken a few days apart, you have azoospermia.

The treatment of azoospermia depends on its causes. If hormonal imbalance is the leading cause of this problem, you have to take hormone medications, but if the cause of azoospermia is the blockage of sperm ducts, you may have to undergo surgery. 

Factors Affecting Spermogram Test

If you are about to take a spermogram test, you should know that some factors can affect the result. These factors include:

• Using drugs such as cocaine, marijuana, and tobacco;
• Using too much caffeine;
• Using hormonal and chemotherapy medicines;
• Wearing tight underwear for an extended period;
• Take a hot bath every day;
• Taking herbal supplements without prescription; 
• Constant exposure to heat, radiation, and chemicals; and
• Not ejaculating for more than a week.

Abstinence Before Sperm Analysis 

One key factor that significantly influences the outcome of a semen analysis is the duration of abstinence before the test. Known as the "abstinence period," it refers to the number of days a man refrains from ejaculation before providing a semen sample for analysis. Striking the right balance is essential, as both excessive and insufficient abstinence can impact the reliability of results.

Typically, doctors recommend a period of 2 to 5 days of abstinence before sperm analysis. This timeframe allows for accumulating sufficient sperm, providing a comprehensive overview of their count, motility, and morphology. Adhering to the recommended abstinence period ensures that the semen sample represents an accurate reflection of the individual's reproductive health, contributing to a more precise diagnosis and tailored fertility guidance.

Providing Semen Samples at Home

If you are uncomfortable providing a semen sample for a sperm analysis in the fertility clinic, you can do it at home. In this method, you must pour your semen into a special container provided by the laboratory and take it to the laboratory for examination. In this method:

• Keep the special container in a place away from any pollution;
• Do not leave the container open before pouring the sample into it;
• Keep the sample in a place where the temperature is similar to the body temperature;
• Transfer the sample to the laboratory within one hour;
• Make sure that all the semen is poured into the container during ejaculation; 
• The volume of the sperm sample should be between 2 and 5 ccs, and
• If sample taking is not done correctly, wait 24 hours and repeat it.

Semen Analysis and Other Fertility Tests

It is worth mentioning that if your semen test’s results are reported to be abnormal, your doctor may suggest that you take other tests such as: 

• Genetic testing (also called DNA test);
• Hormone test;
• Post-ejaculation urinalysis (PEU);
• Follicle-stimulating hormone (FSH);
• Prolactin;
• Testicular biopsy (taking samples from testicles); and
• Antisperm antibody test.

The Final Word

A semen analysis can provide information that may help determine the factors affecting your fertility. In addition, most fertility specialists prefer to have your complete medical history and do physical examinations to identify the cause of infertility precisely.

In Iran, semen analysis is highly accurate in modern fertility clinics. If you intend to take a spermogram in Iran, Contact Raadina Co. to get more information about the price of semen analysis in Iran, the best fertility clinics in the country, and how to get an Iran medical visa.

FAQs about Semen Analysis

1) What factors are examined in a semen analysis?

In semen analysis, factors such as sperm count, motility, and morphology, as well as the semen pH, appearance, and concentration, are examined. Mainly, a spermogram is done to detect the cause of male infertility.

2) What do abnormal sperm test results mean?

If the sperm does not meet the expected standards, it will not be able to penetrate the egg and fertilize it. Abnormal sperm test results may indicate that the male partner is infertile or has an infection, genetic disorder, or hormonal imbalance.

3) How long does it take for semen analysis results to be prepared?

Usually, the results of semen analysis are prepared a couple of hours after providing the semen sample. 

4) What factors affect the results of a spermogram?

Some of the factors that can affect the results of the spermogram are:

• Undergoing radiotherapy and chemotherapy;
• Taking drugs to treat prostate;
• High blood pressure and its medications;
• Using steroids for an extended period; and
• Taking testosterone supplements, anti-inflammatory medications, and antifungal drugs.