Diagnosis – the first step to a baby

A semen analysis is an important diagnostic tool for investigation of male fertility. The assessment is carried out according to WHO guidelines, with a focus on concentration, motility and morphology of the sperm.

Semen analysis

In a semen analysis, the ejaculate is examined under a microscope to evaluate male fertility. The term semen analysis includes all tests carried out during the examination of the sperm.

Semen analysis is therefore the most important male fertility test. The sperm sample is produced by masturbation, where possible under sterile conditions directly at the place of examination, so the sample can be quickly processed and analysed. The laboratory examines the ejaculate under the microscope. Whether poor sperm is the cause of sub- or infertility can only be established from looking at all factors, including quantity, motility and quality of sperm. A low number of sperm in the ejaculate does not necessarily mean sterility, however, it may take longer until an egg is successfully fertilised. Low sperm motility or morphology can have a negative impact on natural procreation.

 

WHO 1999

WHO 2010

Ejaculate volume

0.07 fl oz

0.05 fl oz

Total sperm count in ejaculate

40 mill.

39 mill.

Sperm count

20 mill/0.03 fl oz

15 mill/0.03 fl oz

Progressive motility

50%

32%

Vital sperm

75%

38%

Morphologically normal sperm

30%

4%

Overall motility

50%

40%

pH Value

≥ 7.2-7.8

≥ 7.2

WHO definition of a semen analysis (comparison of 1999/2010)

WHO criteria of a normal semen analysis

  • An ejaculate of at least 0.05 fl oz should contain more than 15 million sperm per 0.03 fl oz of semen. At least 32% should swim in a forward direction, and at least 4% should have a normal shape. If these criteria are met, the man is considered fertile.
  • In addition to the findings of the semen analysis, the ejaculate should not contain more than 1 million white blood cells and microorganisms per 0.03 fl oz ejaculate. To be certain, the ejaculate should be analysed twice.
  • Intervention is required, if the semen analysis is abnormal or shows one or more deviations.
  • Sperm concentration: The current WHO standard states that there should be at least 15 million sperm cells per 0.03 fl oz. The ejaculate volume should be at least 0.05 fl oz millilitres.