Tests that may be done during a semen analysis include:
¾ Volume: This is a measure of how much semen is
¾ Liquefaction time: Semen is a thick gel at the time
of ejaculation and normally becomes liquid within
30 minutes after ejaculation. Liquefaction time is a
measure of the time it takes for the semen to liquefy.
¾ Sperm count: This is a count of the number of sperm
present per milliliter (mL) of semen in one ejaculation.
¾ Sperm morphology: This is a measure of the percentage
of sperm that have a normal shape.
¾ Sperm motility: This is a measure of the percentage of
sperm that can move forward normally. The number
of sperm that show normal forward movement in a
certain amount of semen can also be measured (motile
¾ pH: This is a measure of the acidity (low pH) or alkalinity
¾ White blood cell count: White blood cells are not
¾ Fructose level: This is a measure of the amount of a sugar
called fructose in the semen. The fructose provides
A semen analysis is done to determine whether:
¾ A man has a reproductive problem that is causing
¾ A vasectomy has been successful
¾ The reversal of a vasectomy has been successful.
The patient may be asked to avoid any sexual activity that
results in ejaculation for 2 to 5 days before a semen analysis.
This helps ensure that his sperm count will be at its highest,
and it improves that reliability of the test. If possible, the
patient should not avoid sexual activity for more than 1 to
2 weeks before this test, because a long period of sexual
inactivity can result in less active sperm.
Ask the patient to avoid drinking alcohol for a few days
Ask the patient about any medications or herbal
Ask the patient to produce a semen sample, usually by
ejaculating into a clean sample cup. He can do this in a
private room or in a bathroom at your office or clinic. If
patient lives close to your health professional’s office or
clinic, he may be able to collect the semen sample at home
and then transport it to the office or clinic for testing.
¾ The most common way to collect semen is by
masturbation, directing the semen into a clean sample
¾ The patient can collect a semen sample during sex
by withdrawing his penis from his partner just before
ejaculating (coitus interruptus). He then ejaculates into
a clean sample cup. This method can be used after a
vasectomy to test for the presence of sperm, but other
methods will likely be recommended if the patient is
¾ The patient can also collect a semen sample during sex
by using a condom. If he uses a regular condom, he will
need to wash it thoroughly before using it to remove any
powder or lubricant on it that might kill sperm. He may
also be given a special condom that does not contain
any substance that kills sperm (spermicide). After he
has ejaculated, carefully remove the condom from his
penis. Tie a knot in the open end of the condom and
place it in a container that can be sealed in case the
If the patient, collect the semen sample at home, the
sample must be received at the laboratory or clinic within
1 hour. Keep the sample out of direct sunlight and do not
allow it to get cold or hot. If it is a cold day, carry the semen
sample container against his body to keep it as close
to body temperature as possible. Do not refrigerate the
Since semen samples may vary from day to day, 2 or
3 different samples may be evaluated within a 3-month
A semen analysis to test the effectiveness of a vasectomy
is usually done 6 weeks after the vasectomy.
Producing a semen sample does not cause any discomfort.
However, the patient may feel embarrassed about the
method used to collect it. If masturbation is against his
religious beliefs, discuss alternate methods of collection
There are no risks associated with collecting a semen
A semen analysis measures the amount of semen a man
produces and determines the number and quality of
sperm in the semen sample. Results of a semen analysis
are usually available within a day. Normal values may vary
from laboratory-to-laboratory.
Certain conditions may be associated with a low or
absent sperm count. These conditions include orchitis,
varicocele, Klinefelter syndrome, radiation treatment to
the testicles, or diseases that can cause shrinking (atrophy)
of the testicles (such as mumps). If a low sperm count or a
high percentage of sperm abnormalities is found, further
testing may be done. Other tests may include measuring
hormones, such as testosterone, luteinizing hormone
(LH), follicle-stimulating hormone (FSH), or prolactin.
A small sample (biopsy) of the testicles may be needed
for further evaluation if the sperm count or motility is
Factors that can interfere with semen test or the accuracy
¾ Medicines, such as cimetidine (Tagamet), male and
female hormones (testosterone, estrogen), sulfasalazine,
nitrofurantoin, and some chemotherapy medicines
¾ Caffeine, alcohol, cocaine, marijuana, and smoking
¾ Herbal medicines, such as St. John’s wort and high
¾ A semen sample that gets cold, the sperm motility value
¾ Exposure to radiation, some chemicals (such as certain
pesticides or spermicides), and prolonged heat exposure
¾ An incomplete semen sample: This is more common
if a sample is collected by methods other than
¾ Not ejaculating for several days: This may affect the
400 Concise Book of Medical Laboratory Technology: Methods and Interpretations What to Think About?
¾ A semen sample collected at home must be received
at the laboratory or clinic within 1 hour. Keep the
sample out of direct sunlight and do not allow it to get
cold or hot. If it is a cold day, carry the semen sample
container against your body to keep it as close to body
temperature as possible. Do not refrigerate the semen
¾ Consistently detecting sperm in the semen of a man
who has had a vasectomy indicates that his surgery was
not successful, and another form of birth control should
be used to prevent pregnancy. A low number of sperm
may be present in a semen sample taken initially after
a vasectomy. However, sperm should not be present in
¾ A man whose mother took the medicine diethyl
stilbestrol (DES) during her pregnancy with him has
a greater-than-normal risk of being unable to father a
¾ Additional tests may include measuring hormone
levels, such as testosterone, luteinizing hormone (LH),
follicle-stimulating hormone (FSH), or prolactin. For
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