Semen Analysis Explained — What Your Report Actually Means
A semen analysis is the single most important test in male fertility — and the one men dread for all the wrong reasons. It takes one visit, costs a few hundred rupees, and answers half the diagnostic picture of any couple’s infertility. If you’re reading this, you either just got your results or you’re working up the courage to go. Either way, here’s what the numbers mean.
The Three Numbers That Matter
1. Concentration (Count)
WHO reference: 16 million per millilitre or above.
Below this is called oligospermia. Mild reductions (10–15M) often work with IUI after washing; significant reductions (below 5M) usually point toward ICSI, where only one sperm per egg is needed. Zero sperm (azoospermia) needs investigation — obstructive causes often have surgical solutions.
2. Motility (Movement)
WHO reference: 42% total motility, with at least 30% progressive (swimming forward).
Sperm that can’t swim can’t reach the egg. Poor motility (asthenospermia) is often linked to varicocele, infection, or lifestyle factors. In IUI, the lab washes and selects the best swimmers; in ICSI, motility becomes irrelevant because the embryologist selects and injects directly.
3. Morphology (Shape)
WHO reference: 4% or more normally shaped forms (strict criteria).
Yes, the bar really is that low — nature produces mostly imperfect sperm, and only a small percentage need to be normal for natural conception. Below 4% (teratospermia) is a mild concern; below 1% pushes toward ICSI, where visual selection under magnification compensates.
Other Values on Your Report
Volume: 1.4 ml+ — low volume can indicate a collection issue, retrograde ejaculation, or ductal obstruction. pH: 7.2–8.0 — abnormal levels suggest accessory gland issues. Liquefaction: should happen within 30 minutes — failure may indicate infection. White blood cells: elevated counts suggest infection or inflammation requiring treatment before conception attempts.
One Bad Report Is Not a Diagnosis
This cannot be emphasised enough. Sperm parameters swing with illness (even a flu 2–3 months prior), fever, stress, poor sleep, alcohol, heat exposure, and abstinence timing (too long reduces motility; too short reduces volume). Any surprising result must be repeated after 4–6 weeks under proper conditions — 2–5 days abstinence, no sauna, no illness in the prior 3 months. A diagnosis rests on the pattern across reports, not one snapshot.
What to Do With Your Results
Everything normal: The male side is likely not the issue — investigation shifts to her. Continue for 6–12 months (depending on age) before escalating, with repeat analysis if no pregnancy.
Mildly reduced: Lifestyle optimisation for 10 weeks (the 10-week project), then repeat. If still reduced, IUI is a reasonable first step for most couples.
Significantly reduced: Fertility specialist consultation. Depending on diagnosis: varicocele repair, hormonal treatment, or direct to ICSI-IVF. Consider sperm freezing if values are declining over time.
Azoospermia: Not the end — surgical retrieval (TESA/Micro-TESE) finds usable sperm in many cases, and ICSI can work with as few as a handful of viable sperm. Read our male infertility guide.
Getting Tested in Ahmedabad
Every fertility clinic and most pathology labs in Ahmedabad offer semen analysis. Cost: ₹300–800. The test should always be the first step in any couple’s fertility workup — before any invasive testing on the female partner. Half the picture, one visit, a few hundred rupees. Ask Pregology if you need help choosing a verified clinic.