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Semen Analysis – What Is Measured ?

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Experts estimate that malefactors are to blame in up to 40% of couples which experience fertility issues. As a result, many couples find it extremely helpful for the man to undergo a semen test at the earliest sign of difficulty in trying to conceive.

Compared to many of the female fertility tests and exams, semen analysis is non-invasive, relatively inexpensive, and produces results quickly and accurately. Semen analysis  is a valuable tool for couples as they begin their fertility journey.

Using the ExSeed device to test sperm quality, you can get the same results as analyzing in the clinic using a microscope.

Fig 1

Firstly, semen is the fluid a man ejaculates during orgasm while the sperm cells within the semen are the cells that can fertilize the woman’s egg. For most semen tests, the man is asked to masturbate into a container, which is then delivered to a laboratory for testing.  Almost all laboratories performing sperm tests will evaluate the following semen and sperm parameters:

 

 

 

Semen Volume: Semen volume is the total quantity of fluid that is ejaculated. A normal amount is between 2 and 5 milliliters. A volume of less than 1.5ml is called Hypospermia and can, for example, be caused by the presence of hormonal abnormalities or ductal blockages. A large volume of more than 5.5ml is called Hyperspermia.

Sperm Count: Sperm count is determined by looking at the semen sample under a microscope and is a measurement of how many million sperm cells there are in each milliliter of semen. In the literature it also called “Sperm concentration”.

A normal sperm count is 15 million or more sperm cells per milliliter. Being below 15 million sperm cells per milliliter is referred to as oligospermia, and if there are no sperm cells at all, azoospermia, see figure 2.

Sperm Motility (or “Sperm movement”)

Sperm motility is defined as the forward swimming motion of sperm. For a sperm to fertilize the egg, it must travel quickly through the female reproductive system, which requires strong swimming action. The World Health Organization (WHO) grades motility as follows [1];

Progressive motility (PR): spermatozoa moving actively, either linearly or in a large circle, regardless of speed.

Non-progressive motility (NP): all other patterns of motility with an absence of progression, e.g. swimming in small circles, the flagellar force hardly displacing the head, or when only a flagellar beat can be observed.

Immotility (IM): no movement.

To have more than 32% of progressively motile sperm cells (PR) or 40% as a combination of progressive motile and non-progressive motile (PR and NP) is considered normal. Asthenozoospermia (see figure 2) refers to a condition where a great portion of sperm in a semen sample which are immotile or have reduced motility, compared to the WHO reference values.

Total Motile Sperm Count (TMSC): The total motile sperm count refers to the total number of moving sperm cells in the entire ejaculate.

It is calculated by multiplying the volume (ml) by the concentration (million sperm/ml) by the motility (% moving). Ideally, the TMSC should be above 39 million sperm cells.

Fig 2

In fertility clinics, the above 4 semen parameters are considered to be enough for their initial sperm quality assessment. However, if any abnormalities are discovered or indeed infertility persists, one may go to a clinic for a further, more comprehensive, analysis. Such analysis may include:

Sperm Size and Shape

Also known as sperm morphology. Abnormal sperm cells may be unable to move normally or to penetrate an egg. As a result, too many sperm cells of abnormal size and shape can pose a significant fertility issue.

Most laboratories will evaluate the sperm cells based on the criteria provided by the World Health Organization (WHO) which is called the “Kruger” criteria. According to the Kruger criteria, a normal sperm cell must have an oval shape with a smooth outline. To be considered normal, at least 4% of the sperm cells must have an oval head with a connecting mid-piece and a long straight tail.

Take a look at figure 2 to see how a normal sperm cell should look. If under 4% of a sample is normal, the condition is referred to as Tetrazoospermia. 

Fig 3: showing what is considered a normal shaped sperm cell (left) and what is considered abnormal (all the other cells shown).

 

Color and viscosity

An evaluation of the color and viscosity (how thick the semen is) of the seminal fluid, and the time until the semen sample liquefies, is often included in a comprehensive semen analysis.

The color should be grey-opalescent. If it appears red-brown, it may be an indication of red blood cells in the ejaculate (Haemospermia). It’s normal for the semen to liquefy in no more than 20 minutes. If it doesn’t liquefy, it may indicate the presence of an infection of the seminal vesicles and/or the prostate.

Semen pH

Semen is typically a slightly alkaline substance, with a normal pH of 7.2-8.0. An abnormally high or low semen pH can cause sperm death and impact the ability of the sperm to swim quickly and or effectively penetrate the egg.

Sperm Vitality

Sperm vitality relates to how many sperm cells are alive and intact. To determine sperm vitality, a dye is used where only the dead sperm are stained because they are not intact anymore. For a semen sample to be considered normal, the percentage of live sperm should be above 58% – below is referred to as Necrozoospermia.

White blood cell infiltration

While it’s normal for semen to contain some white blood cells, many white blood cells in a semen sample may indicate the presence of an infection, which can decrease semen quality. It’s considered normal to be below 1 million white blood cells per milliliter of semen- above that is called as Leukospermia.

Presence of zinc, fructose, and glucosidase in the semen

A range of different nutrients is released from accessory glands in the male reproductive system. Some of these include, zinc, fructose and glucosidase. There should be above a certain limit of these markers for the semen to be considered normal; zinc (≥2.4 µmol/ejaculate), fructose (≥ 13 µmol/ejaculate), and glucosidase (≥20 µU/ejaculate).

What is needed to assess semen quality?

For a sufficient first line test of sperm quality, the following is needed:

  • Semen volume
  • Sperm concentration
  • Sperm motility
  • Total Motile Sperm Count (TMSC)

All of the above information can be obtained by using the ExSeed device. According to the scientific evidence, TMSC is the best indicator of how big the chances are for reaching pregnancy. ExSeed is the only home sperm test device that can provide this on the market.

What, when, where, and how?

There is no perfect semen analysis test. Some men with low sperm counts can achieve pregnancies without assistance. Other on the other hand with normal sperm count are unable to get pregnant with their partner.

In general, men with better semen parameters have a better chance of reaching pregnancy faster in the process. Optimizing these parameters as much as possible is therefore beneficial for fertility.

At ExSeed Health we encourage all men to have an assessment of sperm concentration and motility. This should be done as early as possible to allow time to improve the quality if any inconsistencies are found.

 

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23 thoughts on “Semen Analysis – What Is Measured ?”

  1. Avatar

    My spouse and I absolutely love your blog and find almost all of your post’s to be just what I’m looking for. Do you offer guest writers to write content for yourself? I wouldn’t mind writing a post or elaborating on a few of the subjects you write in relation to here. Again, awesome web site!

  2. Avatar
    Waqas Muhammad Sadiq

    My sperm volume is 6ml
    Sperm count 360 million
    Progressive motility is 20 percent
    Sluggish is 45 percent
    Please update me about my report

    1. Emil Andersen

      Dear Waqas,
      We use the number total motile sperm count to estimate semen quality. In your case, we get 12 million motile sperm.
      This is what we classify as a moderate quality, translating in an approximate chance of reaching pregnancy per cycle on 12-18%, which of course is also dependent on your partner.
      Please see this article for more information on the topic: https://www.exseedhealth.com/can-you-increase-the-strength-of-your-swimmers/
      Kind regards
      Emil

  3. Avatar

    So I have a 2.0 volume
    Count (mil.cc) 25
    Motility 80
    Grade 3
    Ph 8.0
    Rounds cells IPF 6

    Please advise your thoughts on results – keep in mind I just had a reversal 3 months ago

    Thanks !!!

    1. Emil Andersen

      Dear Mike,

      From your report, it seems that the reversal has worked. Your semen quality is in what we categorize as in the moderate range, because you have 40 million motile sperm cells per ejaculate. For more information on the topic, please see this article: https://www.exseedhealth.com/can-you-increase-the-strength-of-your-swimmers/

      If you are in doubt about the reversal, I recommend that you reach out to the facility that performed the reversal procedure.

      Kind regards
      Emil

  4. Avatar

    Hi There,

    Semen volume :4.5 ml
    Count : 40 million/ml
    Total sperm count: 180 million
    Sperm motility:60%
    Progressive Motility: 54 million
    Slow and non-progressive: 54 million
    Non Motile: 72 million
    Liquification time:40 mins

    Can you review the report and let me if this is normal.

    1. Emil Andersen

      Dear Reddy,

      From your report, it does look normal.

      We use the number of total progressively motile sperm cells to estimate the semen quality. In your case, you have 54 million motile sperm cells. This is classified as an optimal quality.
      For more information on the topic please see this article: https://www.exseedhealth.com/can-you-increase-the-strength-of-your-swimmers/

      Even men with a normal semen quality can experience problems reaching pregnancy with their partner, and a sperm test is a good option to check if something could be limiting your chances.

      Kind regards
      Emil

  5. Avatar

    After I originally left a comment I seem to have clicked the -Notify
    me when new comments are added- checkbox and from now on each time a comment is added
    I recieve 4 emails with the same comment. Is there an easy
    method you can remove me from that service? Thank you!

  6. Avatar
    Beatriz Pacheco

    Greetings! Very helpful advice within this article! It is the little changes that make the most significant changes. Thanks a lot for sharing!

  7. Avatar

    Hola
    Estos resultados están bien?
    El estudio me lo hice hace medio año y pronto me haré otro, debido a asuntos médicos.
    Eyaculado total: 6 ml
    Espermas por mililitro: 16 millones
    Espermas en el eyaculado: 96 millones
    Movilidad progresiva: 40%
    Movilidad no progresiva: 10%
    Espermas normales: 36%
    Anormales: 64%

    1. Avatar

      Hi
      Volume 2ml
      Count 15million
      Motile 35%
      Sluggish 20%
      Non motile 45%
      Morphology 15%
      Please review my report and if this is normal.

    2. Avatar

      Hi there
      Plz help me with my husband semen analysis results
      Volume -5min
      PH 8.0
      Total sperm count 13.5ml/ml
      Progressive motile-0
      Non progressive-35
      Sluggish motile-30
      Non motile-25
      Abnormal form-10

  8. Avatar

    Hola
    Estos resultados están bien?
    El estudio me lo hice hace medio año y pronto me haré otro, debido a asuntos médicos.
    Eyaculado total: 6 ml
    Espermas por mililitro: 16 millones
    Espermas en el eyaculado: 96 millones
    Movilidad progresiva: 40%
    Movilidad no progresiva: 10%
    Espermas normales: 36%
    Anormales: 64%

  9. Avatar

    I’m impressed, I must say. Seldom do I come across a blog that’s both equally educative and engaging, and let me tell you, you have hit the nail on the head. The issue is something too few men and women are speaking intelligently about. Now i’m very happy that I came across this in my hunt for something concerning this.

    1. Avatar

      Volume 5.3
      Number if sperm on smear 2
      Seem concentration mill
      Total speed count mill
      Motility 0%
      Forward progression 0

  10. Avatar

    If my sperm count is 86 million/ml and all other parameters are normal except semen volume. My semen volume is 1.5 ml. Can I make my wife pregnant.

  11. Avatar

    Hi there,

    Firstly, thank you for your post. Please is it possible to have an opinion on these results:

    Volume (ml): 5
    Density (million/ml): 75
    Progressive motility (%): 60
    Progression: 2-3
    Normal forms (%): 4

    Thank you!

  12. Avatar

    Hi – Please find the semen analysis report below. Can you please provide your inputs

    Semen volume :4.2 ml
    Sperm concentration : 12 million/ml
    Total motility count: 31 million
    Sperm motility:60%

  13. Avatar

    hye
    my sperm report are
    total sperm count 65
    active cell 35%
    non active 10%
    dead cell 35%
    ssluggish cell 20 %
    puss cell 26-28 ph

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