Semen analysis explained, How to read the report?

Why do you need to do semen analysis?

Semen analysis can help to assess 3 important cases: the fertility status of a man, the success of vasectomy operation and detection of infection. Male fertility can be assessed from the quantity and quality of sperm, while presence of pus cells and red blood cells indicate infection in somewhere in the male genital organs. Absence of sperm means success of vasectomy. 

How is semen analysis done?

To do semen test, you need to submit a sample of your semen to the laboratory. The result may be ready in about 4 hours after the semen sample is delivered to the laboratory.

How to collect the semen sample?

Semen can be collected at 2 sites, the laboratory itself, or at home, then deliver it to the laboratory within 30 to 60 minutes. Collecting the sample at the laboratory is preferred to ensure quick submission without delay, which is important to calculate the liquefaction time.

Semen analysis is an easy test with fast result delivered, therefore, it is usually the first to be requested for couples complaining of infertility, or delayed pregnancy. 

How useful is semen test?

Semen test report contains many useful data, that can help assess man infertility and health status , which include: sample size, liquefaction time, pH value, and date collected by microscopic examination. Microscopically, we can know: the number of sperm, their shape, motility, and the presence of white blood cell in the sample.

Semen analysis report

When do you need a semen analysis?
The couple stay together more than one year without pregnancy, then it is considered a case of infertility, therefore , the man should do the semen test.

The semen analysis report is divided into several sections, usually of 3 sections, the first is general information about the sample, the second is about its physical properties, which we see by naked eye or using some chemical solutions, then the third contains the results of microscopic examination of the sample.

Section 1: semen sample general information

The data in this section includes the following:
1- Period of abstinence from sexual intercourse, which may affect the number and quality of sperm. The ideal is no sex for 3 – 7 days.
2- Collection time, which is used to calculate the liquefaction time, and to calculate the percentage of motile sperm after one hour, 2 hours, then 3 hours.
3- Liquefaction time, The normal time ranges between 20-30 minutes after ejaculation. Some bacterial diseases (infection) in the testicle may cause prolonged liquefaction time.

Section 2: Physical Properties of the semen

Appearance: Greyish white is the normal color of semen. The color may change due to infection or presence pf red blood cells.
Sample volume – The healthy volume ranges between 2-6 ml. Infertility may be due to the small size of the sample, which may be the result of an infection or a varicocele.
Acidity level (pH): Semen is normally alkaline, between 7.2-8 , which is contributed by prostatic secretions. Excessively low or high acidity can lead to the death of sperm cells or an imbalance in their movement.

Section 3: Microscopic examination

1- Sperm count:

Normal sperm count is 15 million sperm per milliliter or more. After ligation , the success of vas ligation is measured by the absence of sperm cells, it means 0 cells. A low sperm count can indicate a problem with production, due to hormonal problems or due to an infection / inflammation or chemical injury to the testicle.

2- Morphology:

At least 70% of the sperm are with normal shape and structure. Ill-shaped sperm cells are cells that contain two heads, for example, two flagella or two tail, a short flagellum, or a round head (instead of being oval). The abnormal shape makes it difficult for the sperm cell to enter the egg. There are many causes for the shape problems in the sperm cells, including chemical injury (rays) to the sperm cells, infection or orchitis.

3- Motility:

Normally at least 60% of sperm are moving properly.

4- White blood cell count:

There are , normally, no white blood cells or infectious agents in the semen at all. The appearance of white blood cells indicates the presence of inflammation or infection in the testicle.

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