How Is a Sperm Test Done in Men? A Complete Semen Analysis Guide 2026
Approximately 15% of couples have difficulty achieving pregnancy. In half of these cases, the male factor is the determining or contributing role. A semen analysis (sperm analysis) is the first and most fundamental step in evaluating male infertility. With proper preparation and proper interpretation, it provides extremely valuable information.
What Is a Semen Analysis?
A semen analysis is a comprehensive laboratory test that evaluates the number, motility, morphology, and other characteristics of sperm in ejaculate. The World Health Organization (WHO) 2021 guidelines constitute the currently valid reference standard.
Preparation Before a Semen Analysis
Preparation is critically important for test accuracy:
- Sexual abstinence: 2–7 days (preferably 3–5 days) of abstinence from sexual intercourse and masturbation before the test. Shorter or longer abstinence negatively affects results.
- Alcohol and tobacco: It is recommended to stop at least 3 days before the test
- Sauna and steam bath: Should be avoided for 2–3 weeks beforehand (heat reduces sperm quality)
- Febrile illness: High fever experienced within the last 3 months may negatively affect results; inform the laboratory of this
- Medications: Inform the laboratory of all medications you are taking
How Is the Sample Collected?
- The sample is collected through masturbation into a clean container
- It is preferably collected at the laboratory; if collected at home, it must be delivered within 30–60 minutes and must not be exposed to heat
- A condom must not be used (latex impairs sperm quality)
- Lubricant products must not be used for masturbation
Parameters Measured in Semen Analysis
1. Volume
Normal: ≥ 1.4 mL
Low volume may indicate retrograde ejaculation, obstruction, or seminal vesicle problems.
2. Sperm Concentration (Density)
Normal: ≥ 16 million/mL
3. Total Sperm Count
Normal: ≥ 39 million/ejaculate
4. Motility
Normal: Total motility ≥ 42%, progressive motility ≥ 30%
- PR (Progressive motility): Forward movement
- NP (Non-progressive): Movement present but cannot progress
- IM (Immotile): Not moving
5. Morphology (Shape – Kruger Criteria)
Normal: ≥ 4% normal morphology
Evaluates the head, neck, and tail structure of the sperm. Structural abnormalities increase the risk of being unable to fertilize an egg.
6. Vitality
Normal: ≥ 54% live sperm
Distinguishes whether immotile sperm are alive or dead.
7. pH
Normal: ≥ 7.2
Low pH may be a sign of obstruction or infection.
8. Leukocyte Count
Normal: < 1 million/mL
High leukocytes suggest infection or prostatitis.
Understanding Semen Analysis Results
| Term | Definition |
|---|---|
| Normozoospermia | All parameters normal |
| Oligozoospermia | Low sperm count |
| Asthenozoospermia | Low motility |
| Teratozoospermia | Abnormal morphology |
| Oligoasthenoteratozoospermia (OAT) | All three parameters low |
| Azoospermia | No sperm present |
| Cryptozoospermia | Very few sperm (after centrifugation) |
Factors Affecting Sperm Quality
Lifestyle Factors
- Smoking: Impairs sperm count, motility, and DNA integrity
- Alcohol: Affects sperm production by lowering testosterone
- Obesity: Hormonal imbalance and increased scrotal temperature
- Heat exposure: Laptop computers, tight underwear, frequent sauna use
- Stress: Cortisol negatively affects testosterone and sperm quality
- Anabolic steroids: Can completely halt sperm production
The relationship between low testosterone and sperm production →
Medical Causes
- Varicocele: Varicose veins in the scrotum; the most common treatable cause of infertility
- Hormonal disorders: Low FSH, LH, testosterone
- Obstruction (obstructive azoospermia)
- Genetic disorders: Klinefelter syndrome, Y chromosome microdeletion
- History of sexually transmitted infections
- Diabetes, kidney disease
- Chemotherapy and radiotherapy
What to Do If Semen Analysis Results Are Abnormal?
A single abnormal semen analysis is not a definitive diagnosis. The following steps are taken:
- Second semen analysis: Repeat analysis with a 2–4 week interval
- Hormonal panel: FSH, LH, testosterone, prolactin
- Scrotal Doppler ultrasound: Varicocele detection
- Genetic tests: Karyotype analysis, Y microdeletion
- Testicular biopsy: In cases of azoospermia
Treatment Options
- Varicocele treatment: Surgery (varicocelectomy) can improve sperm parameters
- Hormonal treatment: Injection therapy for gonadotropin deficiency
- Clomiphene citrate: To support sperm production
- Antioxidant supplements: Vitamin C, vitamin E, coenzyme Q10, L-carnitine (supportive)
- Lifestyle changes: Quitting smoking, losing weight, avoiding heat
- Assisted reproductive technologies: IUI, IVF, ICSI (intracytoplasmic sperm injection)
Related Articles
- How to Tell If You Have Low Testosterone? →
- How to Improve Sexual Performance in Men? →
- Ways to Increase Libido in Men →
Important Note: This content has been prepared for general informational purposes only. Please consult a urology or reproductive health specialist for sperm testing and infertility evaluation.
Frequently Asked Questions (FAQ)
How long does it take to get semen analysis results? Results are generally available on the same day or within 1–2 business days. Some additional tests (detailed morphology, DNA fragmentation) may take longer.
Is a semen analysis painful? No. Since the sample is collected through masturbation, there is no pain or invasive procedure involved.
If the sperm count is low, does that mean fatherhood is impossible? A low sperm count makes natural pregnancy more difficult but generally does not make it impossible. IVF and especially the ICSI method can achieve high success rates even with very low sperm counts. Even in cases of azoospermia, sperm can be obtained through testicular biopsy.
Can sperm quality be improved? Yes. The sperm production cycle is approximately 72 days. Quitting smoking, losing weight, avoiding heat, varicocele treatment, and supplements can produce concrete improvements during this period.
What is a DNA fragmentation test, and is it necessary? The DNA fragmentation index test (DFI) is recommended in cases where semen analysis parameters are normal but pregnancy cannot be achieved, or in cases of recurrent miscarriage. It measures damage to the sperm’s genetic material.
How does varicocele affect semen analysis? Varicocele increases intra-scrotal temperature and raises oxidative stress; sperm count, motility, and morphology can be adversely affected. After surgical treatment, improvement is seen in a significant portion of parameters.