Semen analysis (sperm test): preparation, results and price

A semen analysis measures the quantity and quality of semen and sperm, says MedlinePlus, from the US National Library of Medicine. Semen is the fluid released from the penis at sexual climax (this release is called ejaculation), and it contains the sperm. Other names for the test are sperm count, sperm analysis, semen testing and male fertility test; many people simply call it a sperm test.

The NHS (the UK's National Health Service) says the test checks the amount of sperm in the sample, how fast the sperm move and the shape of the sperm. MedlinePlus says problems such as a low sperm count or sperm that don't move properly can affect the sperm's ability to reach and fertilise an egg.

Follow the instructions you are given. These are the usual steps:

• Do not have sex or masturbate for 2 to 7 days before the test: wait at least 2 days, but not more than 7, because a longer wait can also harm the result. Advice differs a little: one MedlinePlus page says 2 to 3 days, and no longer than 5.
• Pass urine and wash your hands and penis before you collect the sample. MedlinePlus says this keeps bacteria from your skin out of the sample.
• Collect the whole sample into the clean container you are given, without touching the inside of the container. If you miss any of it, tell the laboratory, and do not try to pick up any that missed the container.
• Do not use lubricant or saliva, which MedlinePlus says could harm your sperm, and do not use an ordinary condom.
• If you collect the sample at home, bring it to the laboratory as soon as you can: ideally within 30 minutes, and within an hour at most. Do not let it get hot or cold on the way: MedlinePlus says to keep it at room temperature, or in an inside pocket so that it stays at body temperature.
• Tell us if you have been unwell in the last three months, and about any medicines or supplements you take, as they can affect the result.

A semen analysis report lists several measurements. These are the World Health Organization's lower reference limits (2021), as published by Manchester University NHS Foundation Trust. They come from men whose partners became pregnant within a year: for each measurement, about 95 in every 100 of those men had a result at or above the value shown.

• Semen volume: 1.4 ml
• Sperm concentration (the number of sperm in each millilitre of semen): 16 million per ml
• Total number of sperm in the whole sample: 39 million
• Progressive motility (sperm swimming forward): 30%
• Normal shape (morphology): 4%
• Vitality (live sperm): 54%

Your report may show different ranges: MedlinePlus says normal value ranges may vary slightly among different laboratories.

A result below a limit does not by itself mean you cannot become a father. MedlinePlus says that if your results aren't all normal, it doesn't mean you're permanently infertile, but it does show that your sperm may be part of the reason you and your partner are having difficulty getting pregnant. Your doctor will explain your results.

MedlinePlus says sperm count and semen quality can vary from day to day, so you may need to give two or more samples within a week or two. The NHS says that if the results find a possible problem, you'll have another semen analysis, usually around 3 months after the first test. Your doctor will tell you if and when to repeat the test.

If few or no sperm are found, your doctor may advise hormone blood tests, a scan of the testicles or genetic tests (blood tests that look at your genes).

At MCI in Mirpur the semen analysis is free, together with the first consultation and the woman's ultrasound scan. For patients in Pakistan, sperm freezing is also free.

Ask about the cost of any other tests your doctor advises. See all costs, or read about the other fertility tests for men and women.