Reading a semen analysis report is confusing, and this is completely normal. Sitting with a report, seeing numbers, abbreviations, and words like morphology or asthenozoospermia is kind of overwhelming. Also, it is difficult to understand what the semen analysis number means, right?
First, take a deep breath, and if you want to get clarification before going to the doctor, then make sure to read it correctly.
This complete guide will include semen analysis results explained, what normal analysis values are, what semen analysis numbers mean, and also help you to know where your numbers stand.
Important: As per WHO guidelines, one abnormal semen analysis does not define your fertility. Before drawing any conclusion, it is best to do a minimum of 2 tests, 4 to 1 week apart.
| Parameters | Lower Limit | Borderline Zone | Below Unit |
| Semen Volume | >=1.4 mL | 1.0- 1.4 mL | <1.0 mL |
| Sperm Concentration | >=16 million/ mL | 10-16 million/ mL | <10 million/ mL |
| Total Sperm Count | >=39 million | 20-39 million | <20 million |
| Total motility (PR + NP) | >=42% | 35-42% | <35% |
| Progressive motility (PR) | >=30% | 25-30% | <25% |
| Morphology | >=4$ | 3-4% | <3% |
| Vitality (live sperm) | >=54% | 45-54% | <45% |
| pH | 7.2-8.0 | – | <7.2 or > 8.0 |
| Liquefaction time | <60 minutes | – | >60 minutes |
| WBCs/ Leukocytes | <1 million/ mL | – | >=1 million/ mL |
Source: As per WHO’s 6th edition, Laboratory Manual for the Environment and Processing of Human Semen
Let’s take a look at the parameter, which may help you to know about some concepts. It is based on the WHO 6th Edition Laboratory Manual (2021), and this is mostly used as a global gold standard used by fertility clinics.
Now you should know about each parameter specifically.
As the name suggests, it is the volume of fluid collected or released during ejaculation. It typically ranges between 1.5 and 5 or 5.7 mL, or one-third to one full spoon.
For example:
Your report says,
Sperm concentration defines how densely packed the sperm are in each millilitre of semen.
Based on the WHO’s larger dataset, the lower reference limit is 16 million sperm per millilitre, and a range above that is also considered normal.
Also, the concentration is not a barrier to conception.
But;
Men can have millions of sperm, but they will be unable to reach the egg if they are unable to move forward effectively. Motility is defined as the ability of the sperm to swim effectively. And it is divided into three types in the report:
WHO 2021 Motility Reference Values
Progressive Motility (PR) – 30% or greater
Total Motility (PR + NP) – 42% or greater
Your result shows…
If you have: PR is 30% or greater, and Total Motility is 42% or greater, then: Motility is normal. Sperm movement is normal.
If you have: Less than 30% in the above category, then: This indicates that you have asthenozoospermia. This is one of the most common semen analysis abnormalities. This can be due to improper nutrition, excessive smoking, or excessive alcohol intake.
This concept is majorly misinterpreted and least understood by men, and they worry about it the most. When men read ‘3% normal morphology,’ their first reaction is that 97% of their sperm are defective. This is not true and is not scary, and here is why:
Morphology is the shape of the sperm, including the shape of the head, shape of the middle piece, and shape of the tail, and it is graded by a detailed system called the Kruger strict criteria, where only a sperm with a very close to perfect shape passes the test.
Here is the thing that your report did not mention and that most people do not know:
In an average fertile man, only 4-14% of their sperm have normal morphology.
In fact, most of the sperm of men who have fathered babies are abnormal in shape. Because it is human biology.
As per the WHO 2021 report,
The Lower Limit: ≥ 4% normal forms
Teratozoospermia is used to describe below 4%.
This means that your morphology is not a problem.
Vitality can only be measured when the motility falls below 40%. At this point, it becomes crucial to know whether the sperm are dead or if they are not simply moving.
According to WHO (World Health Organisation) standards, normal sperm vitality should be less than or equal to 54-58%, and it should be measured within an hour of ejaculation.
Round cells or leukocytes in semen are normal, and they can be immature, which is a sign of natural production. When WBCs exceed 1 million per mL, this is known as leukocytospermia, and it is a clear indication of infection or inflammation in the reproductive tract.
If these cells show an elevated number in the report, then the doctor recommend to go fo further urine and semen culture test. This should not be ignored, as it can lead to long-term damage to sperm quality.
As per these numbers, you can analyse whether cells are mature or not, whether sperm are able to swim. And all these are done through a standard microscope.
This is equal to concentration and volume; in short, the actual number of sperm in the entire ejaculated sample. As per WHO, 39 million or above are consider as normal. But if your number starts to drop below this number, then this is a red flag that needs to be improved.
First of all, never rely on one test only, because the sperm parameter changes day to day. One week their result shoes good results, and another week they turn out to be bad. That is why, fertility experts suggest going for at least 2 to 3 tests to know the actual value of semen parameters.
Now, when it comes to borderline, it sits between normal and abnormal. Sperm production is a complete 72-cycle process, and in between, if someone had stressful work, illness, heat exposure, or anything, it shows in the tests. If your month or weeks are stressful just before the test, then the test parameters might vary between borderline numbers.
One abnormal test does not mean you are infertile. Let’s understand the situations which will give you an understanding of what semen analysis numbers mean, and the recommended next step.
| Situation | What does it really mean? | What you should do. |
| Parameters are within range. | Your semen analysis is normal. | Even after that, if the conception does not occur, try tracking your lifestyle factors. |
| One parameter is below the range limit | Comes under borderline results or might be a temporary issue | Go for analysis after 8 weeks of improving lifestyle. |
| Multiple factors are below the limit. | Might be a sign of infertility. | Talk to your doctor, know what the issues are, and implement the changes. |
| Azoospermia (zero sperm) | Can be obstructive or non-obstructive | Medical treatment is needed. |
| Elevated WBCs | Might be an infection or inflammation | Antibodies can improve the infection. Go for a test after the treatment is done. |
| Abnormal pH | Congenital issue or ductal obstruction | Go for a test and lifestyle improvement as the expert suggested. |
Let’s decode some medical terms-
As of now, you must know that one result does not define whether you are fertile or not. You might have been exposed to heat or been ill, and this might have impacted your sperm morphology. Here are the things that you should know-
Semen Analysis help to analyse the quality, quantity and movement of sperm in one sample. This guide might have given a sign on how you can understand your semen analysis report and also mentioned the term which are crucial. First of all, don’t panic, keep yourself calm. One result does not define whether you’re actually fertile or not. Before concluding anything, talk to an expert, and they can help you to know. Moreover, it is always best to adopt healthy habits, a healthy diet, and keep yourself away from heat exposure and chemicals.
Aveya Fertility Centre is helping people to overcome their fear. So if you are also dealing with an issue related to your fertility, contact Aveya Fertility Centre. They are not just any centre, they are specialised in helping couples related to fertility, offer treatment options, guide them related to any concerns and also support through guidance.