How to Interpret Semen Analysis? Learn in 1 Minute

Pre-pregnancy examination is essential for men, and semen analysis is the most fundamental test in male pre-pregnancy examination. It provides a visual, clear, and rapid evaluation of male fertility. Semen analysis is also used to assess male infertility issues such as oligozoospermia (low sperm count), asthenozoospermia (poor sperm motility), teratozoospermia (abnormal sperm morphology), and azoospermia (absence of sperm). When patients receive their semen analysis reports, they may feel overwhelmed by the dense text and numbers, unsure of how to interpret them.

Today, I will teach you how to interpret a semen analysis report. By the end, you will have a general understanding of your sperm quality!

1. Semen Volume (2ml-6ml):

The normal semen volume for a single ejaculation is between 2ml and 6ml. Less than 2ml is considered low semen volume, while more than 7ml is considered high semen volume. The semen volume can vary based on the duration of sexual abstinence. It is recommended to abstain from sexual activity for 3-7 days before semen analysis. In addition, factors such as seminal vesiculitis, prostatitis, nutrient deficiencies, obstructed vas deferens, varicocele, and immune abnormalities can also cause abnormal semen volume.

2. Semen Liquefaction Time (Within 30 minutes at room temperature):

When semen is initially ejaculated, it forms a gel-like consistency due to the coagulation factors secreted by the seminal vesicles, preventing the semen from flowing out of the vagina. Over time, within 0.5-1 hour, the semen naturally liquefies into a thin liquid. When using a glass rod to pick up the semen, the length of the sperm threads should generally not exceed 2 centimeters. If the semen does not fully liquefy within one hour, it is considered incomplete liquefaction, which can affect the free movement of sperm and lead to infertility.

3. Semen Color (Milky White or Pale Yellow):

Normal semen is typically milky white or grayish white and has a distinct odor. However, if there has been a long period of sexual abstinence or the presence of inflammation, the semen may appear light yellow, yellow, or even abnormal colors such as bloody, streaked with blood, or brown.

4. PH Value (7.2-8.0):

Normal semen has a slightly alkaline pH value of 7.2-8.0. Values below 7 or above 8 can affect sperm activity and metabolism, which is not conducive to conception.

5. Sperm Concentration/Density (Greater than 15 million/ml):

According to the latest WHO criteria, a sperm count lower than 15 million per milliliter is considered oligozoospermia (low sperm count). For sperm to combine with an egg, they must pass through the vagina, cervix, uterine cavity, and reach the ampulla of the fallopian tubes. If the sperm count is insufficient, it becomes difficult to meet the conception standard.

6. Sperm Viability (Greater than 40%):

Sperm viability refers to the proportion of live sperm in a drop of semen. According to the latest requirements of the World Health Organization (WHO) 6th edition, within one hour after ejaculation, the percentage of sperm with motility should be greater than 40%.

7. Sperm Motility (Forward Progressive Motility >32%):

According to the WHO 4th edition diagnostic criteria, A-grade sperm have fast-forward progressive motility, B-grade sperm have slow-forward progressive motility, C-grade sperm move non-progressively, and D-grade sperm are immotile. The combined percentage of A- and B-grade sperm should be greater than 50%, and A-grade sperm should be greater than 32%. However, according to the latest edition, the grading system is no longer used, and it is simply categorized as forward progressive motility, non-progressively motile, and immotile sperm. The standard for forward progressive motility is set at 32%.

8. Sperm Morphology (Less than 96% Abnormal):

Normal sperm have an oval-shaped head, a long and curved tail, resembling a tadpole. However, some sperm may have abnormal morphology, including pointed heads, large heads, double heads, short and thick tails, bifurcated tails, and double tails. Sperm with abnormal morphology cannot fertilize an egg, so it should be less than 4%.

Friendly Reminder: Abnormal sperm morphology does not cause fetal abnormalities.

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