Male Sub-Fertility


Sperm Test Frequently Asked Questions

Semen analysis, also known as a sperm count test, analyzes the health and viability of a man’s sperm. Semen is the fluid containing sperm (plus other sugar and protein substances) that are released during male ejaculation. A semen analysis measures three major factors of sperm health:

  • The number of sperm
  • The shape of the sperm
  • The movement of the sperm, also known as “sperm motility”

Doctors will often conduct two or three separate sperm analyses to get build an idea of your sperm’s health. The tests should be conducted at least seven days apart and over the course of two to three months. Sperm counts can vary on a daily basis. Taking an average of the sperm samples can give the most conclusive and beneficial result.

How to prepare for Semen Analysis

Your doctor will inform what you should do in preparation for the semen analysis. It’s very important to follow these instructions for accurate results.

To get the best sample:

  • Avoid ejaculation for 24 to 72 hours before the test
  • Avoid alcohol, caffeine, and drugs such as cocaine and marijuana two to five days before the test
  • Stop taking any herbal medications, such as St. John’s wort and echinacea, as instructed by your healthcare provider
  • Avoid any hormone medications as instructed by your healthcare provider
  • Discuss any medications you’re taking with your doctor.

How Is Semen Analysis Conducted?

You’ll need to provide your doctor with a semen sample for a semen analysis. There are four main ways to collect a semen sample:


Sex with a condom that does not contain any anti-spermicidal elements

Sex with withdrawal before ejaculation. Please avoid anti-spermicidal lubricants

Ejaculation stimulated by electricity

Masturbation is considered the preferred way to obtain the cleanest sample.

Obtaining a good sample

Two main factors are crucial to having an accurate testing sample. First, the semen must be kept at body temperature. If it gets too warm or too cold, the results will be inaccurate. Second, the semen must be delivered to the testing facility within 30 to 60 minutes of leaving the body.

Test Interference

Some factors can negatively affect the test, including:

  • Semen being in contact with spermicide
  • Taking the test when you’re ill or stressed
  • Inexpert lab technicians
  • Contamination of the sample

There are no known risks associated with a sperm analysis.

If semen analysis results aren’t within normal limits and handling has been ruled out, your doctor may also consider that you are taking the following affecting substances:

  • Alcohol
  • Caffeine
  • Herbs, such as St. John’s wort
  • Prescription drug use of medicines known to reduce sperm count, such as cimetidine
  • Recreational drug use
  • Tobacco

What Are Normal Results?

When a doctor reviews sperm analysis test results, there are many factors to consider:

Sperm Shape

The normal result for a sperm shape test is that more than 50 percent of sperm are correctly shaped. If a man has greater than 50 percent of abnormally shaped
sperm, this reduces his fertility. A laboratory may identify abnormalities in the sperm’s head, midsection, or tail. It’s also possible the sperm could be immature and therefore not able to effectively fertilize an egg.


Normal results are that more than 50 percent of sperm must move adequately an hour after ejaculation. Sperm movement or motility is important for fertility because sperm must travel to fertilize an egg. An automated system analyzes the sperm for movement and rates them on a scale of 0 to 4. A score of 0 means the sperm are not moving and a score of 3 or 4 represents good movement.

pH levels

A pH level should be between 7.2 and 7.8 to achieve a normal result. A pH level higher than 8.0 could indicate the donor has an infection. A result less than 7.0 could indicate the specimen is contaminated or that the patients ejaculatory ducts are blocked.


The volume of sperm for a normal result should be greater than 2 millimeters. A low sperm volume makes it much harder to fertilise an egg. Excess fluid volume could also mean the amount of sperm present is diluted.


It should take 15 to 30 minutes before semen liquefies. While semen is initially thick, its ability to liquefy or turn to a watery consistency helps sperm to move. If semen does not liquefy in 15 to 30 minutes, fertility can be affected.

Sperm Count

A normal semen analysis count should be between 20 million to over 200 million. This result is also known as sperm density. If this number is low, conceiving can be more difficult.


The appearance should be whitish to gray and opalescent. Semen that has a red-brown tint could indicate the presence of blood while a yellow tint could indicate jaundice or be a medication side effect.

What do abnormal results mean?

Abnormal sperm will have trouble reaching and penetrating eggs making conception difficult. Abnormal results could indicate the following:

  • Infertility
  • Infection
  • Hormonal imbalance
  • Disease, such as diabetes
  • Gene defects
  • Exposure to radiation

If your results come back with abnormal levels, your doctor will probably suggest that you take additional tests. These tests include:

  • Sperm DNA testing
  • Genetic tests
  • Hormone testing
  • Testicular ultrasound
  • Urinalysis after ejaculation
  • Taking a tissue sample from your testicles
  • Anti-sperm immune cells testing

I might be suffering from  sub-fertility, what should I do next?

If you have problems conceiving with your partner, have been diagnosed with azoospermia or want to check your sperm health then we advise you to make an appointment to see a specialist Urologist/Andrologist.

Our doctors vast expertise in treating male sub fertility and our clinic is an international referral centre for difficult cases especially those with unexplained infertility.



We would like to reassure you that International Andrology remains fully operational during the lockdown and that as per the government directions, patients can travel to attend medical appointments and treatments. If you are unable to travel, you can have your medical appointment over video or phone.