Semen analysis is the primary investigation for male fertility. It evaluates the quality and quantity of sperm in a semen sample — measuring count, motility (movement), morphology (shape), volume, and other parameters. The results directly determine whether male factor infertility is present and guide the choice between IUI, IVF, or ICSI.
Semen analysis is non-invasive, takes a few minutes to provide, and produces results within 24 hours. It is the single most important male investigation in a fertility workup — yet it is frequently delayed or skipped, resulting in treatment focused on the female partner while the male cause remains unaddressed. At Cloudnine Hospital Kompally, semen analysis is part of every couple's first-cycle workup.
What semen analysis measures
Sperm count (concentration)
Number of sperm per millilitre of semen. WHO 2021 lower reference: 16 million/mL. Below this is oligospermia.
Total sperm count
Total number of sperm in the whole ejaculate. Lower reference: 39 million per ejaculate.
Motility (progressive)
Percentage of sperm moving forward. Lower reference: 30% progressively motile. Below this is asthenospermia.
Total motile count (TMC)
Number of progressively motile sperm in the whole sample — the most clinically useful single number for treatment planning.
Morphology (Kruger strict)
Percentage of sperm with normal shape. Lower reference: 4%. Below this is teratospermia.
Volume
Total volume of ejaculate. Normal range: 1.4–7.6 mL. Very low volume may indicate obstruction or ejaculatory duct issues.
pH
Acidity/alkalinity of semen. Normal: 7.2 or above. Abnormal pH can indicate accessory gland infection.
Liquefaction & viscosity
Semen should liquefy within 60 minutes. Failure to liquefy affects sperm motility and fertility.
Presence of WBCs
White blood cells in semen can indicate infection or inflammation of the reproductive tract.
How to prepare for semen analysis
Abstain from ejaculation for 2–5 days before providing the sample. Fewer than 2 days can reduce count; more than 5 days can affect motility.
The sample is provided by masturbation into a sterile container — at the clinic or at home if within 30 minutes of the lab.
Do not use lubricants — most are spermicidal. If collection at home, transport the sample at body temperature and deliver within 30 minutes.
Avoid alcohol, tobacco, and recreational drugs for at least 3–5 days before the test. These acutely affect sperm parameters.
Inform the lab of any recent illness or fever — a viral illness in the past 3 months can temporarily reduce sperm parameters significantly.
If your result is abnormal, a repeat sample is recommended 4–6 weeks later before making any treatment decisions — sperm production cycles take approximately 74 days, so a single abnormal result may not reflect your baseline.
Understanding your results
Normal Result
All parameters within WHO 2021 reference ranges. Male factor is unlikely to be the primary cause. Treatment focus shifts to ovulatory, tubal, or unexplained factors. IUI with timed intercourse is a reasonable first-line option for eligible couples.
Mild to Moderate Abnormality
One or more parameters slightly below reference — common in couples with unexplained infertility. Lifestyle modifications may help. IUI with ovulation induction is often the next step. ICSI may be considered if the degree of abnormality is moderate.
Severely Abnormal or Azoospermia
Very low count, near-zero motility, or no sperm found in the ejaculate (azoospermia). Further investigation is needed — hormonal tests, genetic testing, and urological review may be indicated. IVF with ICSI, or surgical sperm retrieval (TESA/PESA) plus ICSI, are the appropriate treatment paths.
Repeat Testing
A single abnormal result warrants a repeat test 4–6 weeks later. Temporary illness, stress, heat exposure, or medication can transiently affect sperm. Two consistently abnormal results confirm a true male factor diagnosis and trigger a more detailed evaluation.
What happens after an abnormal result?
Dr Bhavana does not simply hand you a report with out-of-range numbers. An abnormal semen analysis triggers a specific next-step protocol:
Repeat analysis 4–6 weeks later to confirm the finding before planning any treatment.
Hormonal blood tests — FSH, LH, testosterone, prolactin — to identify if a hormonal cause is driving the abnormality.
Referral to a urologist or andrologist if a structural cause (varicocele, obstruction) is suspected.
Genetic testing (karyotype, Y-chromosome microdeletion) for severe oligospermia or azoospermia — relevant for family counselling and treatment planning.
Lifestyle and nutritional review — supplements, weight management, heat avoidance, and cessation of tobacco/alcohol are discussed with realistic expectations.
Treatment recommendation — ICSI or TESA/PESA plus ICSI depending on the severity and confirmed cause of the male factor.
Frequently Asked Questions
Semen analysis results can vary between laboratories due to differences in technique, equipment, and reference ranges used. If your results were done more than 3 months ago, were assessed using older WHO 2010 criteria (rather than 2021), or were performed at a non-specialised general lab, a repeat test at a dedicated fertility lab gives a more reliable and interpretable baseline.
Yes. Male factor infertility is identified in approximately 40–50% of couples who have difficulty conceiving. A semen analysis is the first and most important male investigation — it is non-invasive, inexpensive, and provides critical information that determines the treatment direction for both partners. Delaying the male evaluation prolongs the time to diagnosis without any benefit.
Not necessarily. Azoospermia (no sperm in the ejaculate) has two categories: obstructive (a blockage preventing sperm from reaching the ejaculate) and non-obstructive (reduced or absent sperm production). In obstructive azoospermia, sperm can often be retrieved directly from the testes or epididymis (TESA/PESA) and used in ICSI. Non-obstructive cases are more complex but not always untreatable. Dr Bhavana coordinates with a urologist for a full male factor evaluation before any conclusions are drawn.
Yes — to a degree. Stopping smoking, reducing alcohol, managing weight, avoiding excessive heat to the testes, and supplementing with antioxidants (Vitamin C, E, CoQ10, zinc) have evidence of modest benefit in men with mild to moderate abnormalities. A full sperm cycle takes approximately 74 days, so improvements are not immediate. Lifestyle changes are recommended but should not delay appropriate treatment — particularly when the female partner's age is a factor.
Abnormal result?
Get a clear explanation
Dr Bhavana will go through your semen analysis result with you and tell you exactly what it means and what to do next.