Sperm Analysis: When to Do It and How It Works

Trying to conceive can feel like navigating a maze—especially when months go by without success. A non-invasive, low‑cost test called a sperm analysis (also known as a semen analysis) is often the quickest way to rule in or rule out a male‑factor issue. Below you’ll learn when to do a sperm analysis, how a sperm analysis works, how to read the numbers, and what to do next.

The purpose of the sperm analysis is to determine the answer to these four basic questions:

1. Are there sperm?
2. Are there eggs?
3. Can they find each other?
4. Is the uterus a good place for a baby to be?

A semen analysis is the first step in addressing the first question. This test can be performed without a doctor’s order.

When to Do a Sperm Analysis

Consider booking a sperm analysis if any of the following apply:

1. No pregnancy after 12 months of regular, unprotected intercourse (6 months if the female partner is ≥35).

2. Recurrent pregnancy loss with no clear female‑factor cause.

3. A history of testicular trauma, varicocele, chemotherapy, radiation, or undescended testes.

4. Lifestyle or occupational exposures—heat (long hours cycling), toxins, chronic alcohol intake, vaping, or anabolic steroids.

5. You simply want a baseline fertility check‑up before family planning or prior to vasectomy.

Tip: Schedule the test after 2 – 5 days of abstinence. A shorter or much longer interval can skew the numbers.

How Does a Sperm Analysis Work?

1. Pre‑test preparation

• Avoid ejaculation for 2–5 days.

• Refrain from heavy alcohol, marijuana, or sauna/hot‑tub use for 48 hours.

• Tell the clinic about any medications or supplements.

2. Sample collection

• Preferred: Masturbation into a sterile cup in a private clinic room to keep the sample at body temperature.

• At home: Collect and deliver to the lab within 60 minutes, keeping the cup between 70–100 °F (21–37 °C).

• Alternative options include special collection condoms if masturbation is difficult.

3. Laboratory assessment (30–60 minutes)

• Macroscopic checks: volume, viscosity, pH.

• Microscopic checks: concentration, total count, motility (% moving), progressive motility (% swimming forward), morphology (shape), and signs of infection (white blood cells).

• Advanced tests (if ordered): DNA fragmentation, oxidative stress, or antisperm antibodies.

4. Results & interpretation

• Many labs follow the 2021 World Health Organization (WHO) 6ᵗʰ Edition reference values. Lower 5ᵗʰ‑centile “cut‑offs” include:

  • Volume: ≥ 1.4 mL

  • Concentration: ≥ 16 million/mL

  • Total count: ≥ 39 million/ejaculate

  • Progressive motility: ≥ 30 %

  • Total motility: ≥ 42 %

  • Normal morphology: ≥ 4 % normal forms mft.nhs.uk

• Two tests, 2–4 weeks apart, are recommended if the first is abnormal because sperm quality naturally fluctuates.

Factors That Can Affect Your Numbers

• Medications: testosterone, anabolic steroids, chemotherapy, certain antidepressants.

• Health conditions: varicocele, diabetes, thyroid disease, infections (e.g., mumps orchitis).

• Lifestyle: smoking, vaping, excessive alcohol, high heat exposure, obesity, chronic stress.

• Environmental toxins: pesticides, heavy metals, plasticizers (phthalates, BPA).

What If My Sperm Analysis Is Abnormal?

1. Repeat the test to confirm (sperm regenerate every ~72 days).

2. Consult a fertility specialist or reproductive urologist for a physical exam and hormone panel.

3. Treat underlying issues: repair varicocele, adjust medications, manage diabetes, or start antioxidants.

4. Assisted‑reproduction options:

   • IUI (Intrauterine Insemination) for low count or motility.

   • IVF with ICSI (Intracytoplasmic Sperm Injection) for very low count, poor motility, or severe morphology issues.

5. Lifestyle upgrades: quit smoking, maintain a healthy weight, moderate alcohol, manage stress, and keep laptops & phones off your lap.

Sperm Analysis Frequently Asked Questions

Is a sperm analysis painful?
No. It’s non‑invasive; you simply produce a semen sample.

How quickly will I get results?
Basic results are often available the same day; more advanced tests may take 24–72 hours.

Can I use insurance or an HSA?
Many plans cover diagnostic semen analysis. Check with your insurer or HSA administrator.

Can lifestyle changes really improve sperm?
Yes. A diet rich in antioxidants (fruits, veggies, nuts), regular exercise, and quitting tobacco can boost count and motility within three months.

Do I need a doctor’s order?
Not always. Atlantic Fertility offers self‑referral sperm analysis; results are posted securely to your patient portal.

Making the Call

Atlantic Fertility’s on‑site andrology lab delivers fast, accurate sperm analysis with compassionate care. Call  (919) 248-8777 to book your appointment and start getting answers today.