Semen analysis for low sperm count: Preparation, tests, procedure, and results

Semen analysisSemen analysis or, as most people call it, sperm count tests, can study the health of a man’s sperm and determine if there is in fact a low sperm count. Usually, a semen analysis looks at the number of sperm, the shape of sperm, and the movement of sperm, which is referred to as “sperm motility.” Many people can become nervous about the idea of semen testing, but remaining stress-free is important. Understanding the semen analysis process ahead of time can help ease some of the anxiety.

During a semen analysis, doctors will normally conduct two or three separate tests to make sure that they are getting an accurate reading of sperm health. The American Association for Clinical Chemistry (AACC) recommends that the tests take place at least seven days apart and over a period of about two to three months. Since sperm counts can vary from day-to-day, taking an average of the sperm samples will give the doctor a more accurate result.

Why semen analysis is done


We have addressed the question, what is a semen analysis? Now let’s look at why a semen analysis is done.

A semen analysis test is suggested when a couple is having problems getting pregnant. Essentially, the analysis will help determine whether the man is infertile. It will also show the doctor if low sperm count or sperm dysfunction is an issue. Both low sperm count and dysfunction can be linked to infertility. Reproduction isn’t the only reason for semen analysis, though. There are men who have semen testing done after a vasectomy to ensure that no sperm are in their semen. In a vasectomy, the tubes that send sperm from the testicles to the penis are blocked as a form of birth control. Generally, men take a sperm test once a month for three months following a vasectomy just to make sure there is no longer sperm in their semen.

Preparations for semen analysis

There are specific preparations for semen analysis. It is important to follow your doctor’s instructions; otherwise the semen analysis report may be inaccurate. To get accurate semen analysis test results, a man will usually be told to follow the guidelines listed below:

  • Avoid ejaculation 24 to 72 hours before testing
  • Avoid caffeine, alcohol, and drugs two to five days before testing
  • Stop taking herbal medications
  • Avoid hormone medications
  • Discuss all medication you’re taking with your doctor

Understanding test results of semen analysis

More than one-third of couples that are unable to have children are experiencing a problem with semen or sperm. Those considering semen analysis may be wondering how to read semen analysis. First, it is important to understand what factors get taken into consideration during testing.

  • Volume: This is the measurement of how much semen there is in one ejaculation.
  • Liquefaction time: Semen, which initially has a thick gel texture, becomes liquid within 20 minutes of ejaculation. Liquefaction time is the amount time it takes for semen to turn into liquid.
  • Sperm count: This represents the number of sperm present per milliliter (mL) of semen in one ejaculation.
  • Sperm morphology: This is a measurement of the percentage of sperm with a normal shape.
  • Sperm motility: The measurement of the number of sperm that can move forward in a normal fashion is called sperm motility.
  • PH: Acidity (low pH) and alkalinity (high pH) are measured in semen.
  • White blood cell count: White blood cells aren’t normally found in semen.

Semen analysis results are typically ready within 24 hours. It is natural to be eager to get answers. Semen analysis normal values vary from lab to lab, but the following semen analysis chart will give you a sense of general guidelines.

Reading Semen Analysis Results
VolumeNormal:2-5 mL per ejaculation.
Abnormal:Either low or high semen volume. This can sometimes cause infertility.
Liquefaction timeNormal:20-30 minutes after collection
Abnormal:A long liquefaction time. This could indicate an infection.
Sperm countNormal:20 million spermatozoa per mL or more. If the man has had a vasectomy, then this measure would be 0 sperm per mL.
Abnormal:A very low sperm count. This may mean infertility.
Sperm shape (morphology)Normal:More than 30% of the sperm have normal shape.
Abnormal:The sperm may have two heads or two tails, a short tail, a tiny head, or a round as opposed to an oval head. Abnormal sperm may not be able to move normally or to penetrate an egg. A high percentage of abnormal sperm may make it harder for a man to father a child.
Sperm movement (motility)Normal:Over 50% of the sperm show normal forward movement after 1 hour.
Abnormal:A high percentage of sperm can’t swim well.
Semen pHNormal:Semen pH of 7.1- 8.
Abnormal:Abnormally high or low semen pH, which can kill sperm or impact how well they move or penetrate an egg.
White blood cellsNormal:No white blood cells or bacteria are found.
Abnormal:Bacteria or a large number of white blood cells are present. This could signal an infection.

To summarize, abnormal results could indicate infertility, a hormone imbalance, gene defects, a disease such as diabetes, or radiation exposure. As for normal semen or sperm test results, they will indicate the following:

  • More than 30 percent of sperm are normal shaped
  • More than 50 percent of sperm move normally
  • PH ranges from 7.2 to 8
  • Volume of semen is 2 mL or greater
  • Semen liquefies within 20 to 30 minutes
  • Sperm count is 20 million spermatozoa per mL or more

In a normal reading, the semen should be whitish or gray in color.

What can affect semen analysis results?

There are certain conditions that are believed to be associated with low or zero sperm count. Examples include orchitis, varicocele, Klinefelter syndrome, radiation treatment of the testicles, and diseases that cause testicular atrophy. When a low, absent, or high sperm count is detected, more tests can be conducted, including a hormone measurement or a testicular biopsy.


In terms of treatment, it will depend on what the analysis shows and what the cause of poor sperm health is, but options include everything from antibiotics for an infection to hormone treatments and medications, as well as assisted reproductive technologies and surgery.

Years ago, infertility could be devastating for many young couples eager to start a family. Thankfully, today, advances in treatment mean many people with infertility issues can still have the children they hope for.

Related: Low sperm mobility linked with common chemical exposure


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