Sperm Test Results Explained – Interpretation & Normal Values

By (gynecologist), (embryologist), (gynecologist), (embryologist) and (fertility counselor).
Last Update: 02/10/2021

A semen analysis, also known as sperm test or spermogram, is a type of test to evaluate the quality of a sperm sample and the sperm count. In other words, it is an effective method for determining male fertility.

Broadly speaking, after collecting the semen sample, the clinic analyzes the different sperm parameters in the lab. When the results are ready, a report with the results is provided to the patient. In order to understand them, it is important that you learn how to read them. Here are some key factors to keep in mind when it comes to interpreting a semen analysis.

Semen parameters

The WHO (World Health Organization) has published a series of guidelines as regards the sperm parameters that should be examined in a semen analysis, and has established the reference values to determine if the results are normal or not.

Sperm parameters can be examined macroscopically and microscopically. Continue reading in order to learn how to understand each type of analysis along with the reference values of each:

Macroscopic examination

A macroscopic examination allows the specialist to evaluate the basic characteristics of the sperm sample, that is, the ones that can be seen by the naked eye, without using a microscope. The following are key values:

Measured in milliliters (ml). Samples are considered normal if the volume is above 1.5 ml.
The sample needs to be liquefied for 20 minutes prior to doing the analysis until it becomes totally liquid.
The normal color of the semen is yellowish to greyish. If the sample is too transparent, it may indicate the presence of white blood cells (leukocytospermia). If it is too opaque, it is likely that the sperm count is high.
The specialist measures the length of the threads formed by drops. Threads must break so that the sample can be examined accurately. A sample that is too viscose can indicate prostate problems.
The normal pH of semen ranges between 7 and 8. Variations under or above this range are associated with infections.

Microscopic examination

If a macroscopic examination is more associated with the external traits of the semen and the fluids it is composed of, a microscopic examination focuses on all aspects related to the sperm cells.

To this end, a drop of semen is put in a Makler counting chamber to analyze the following sperm parameters under the microscope:

Sperm count
The total sperm count must be higher than 15 million sperm per milliliter or 39 million per ejaculate in order to be considered normal.
Sperm motility
It is used to examine the percent of motile sperms in the sample, as well as the ones that are able to "swim" in terms of rapidly progressive, slowly progressive, or non progressive. A sperm sample is considered normal when more than 40% of sperm are able to move and over 32% are able to make forward progress.
Sperm vitality
There exist many tests to determine whether there are dead sperm cells in the ejaculate: eosin Y dye test, hypo-osmotic swelling test, etc. For a semen sample to be considered normal, the percentage of live sperm should be above 58%.
Sperm morphology
Hematoxylin and Eosin stain is used to evaluate the morphology of a drop of semen. The sperms are examined one by one to detect the presence of anomalies. Normal forms must be present in at least 4% to consider that the sample is normal.
Presence of WBCs
In case white blood cells (WBCs) are present in the sample, the amount is examined under the microscope. If the presence of WBCs or leukocytes is above 1 million/ml, it is an indicator of infections. This condition is known as leukocytospermia or pyospermia.

You may also enjoy some further information reading this: What Is a Semen Analysis Report? – Purpose, Preparation & Cost.

How to read a sperm analysis report

Once you have the results of the semen analysis, you should consider the following aspects concerning the format in order to understand your report accurately:

  • The WHO's reference values are normally included in brackets next to your result.
  • The sperm count is provided in millions per milliliter (ml).
  • Sperm motility, morphology, and vitality are provided in percentages.
  • The unit measures or reference values used might differ from lab to lab, should you repeat the semen analysis at a different clinic.
  • The WHO's reference values used today are the ones they published back in 2010.

If the results of your spermogram reach the lower reference values of semen variables established by the WHO, your semen analysis report is considered normal. In other words, you don't have any fertility issues. This is known as normozoospermia.

In case any of these parameters fall outside these ranges, the sample will be considered abnormal. These are the different types of sperm disorders that may be diagnosed:

Zero sperm count
Low sperm count
Poor sperm motility
Abnormal sperm morphology
High number of dead sperm
Low sperm volume

It is also possible to have a combination of two or more of these pathologies, such as oligoasthenoteratospermia. The prognosis in these cases will be worse.

In any case, the chances of getting pregnant will depend on the parameter that is affected and the grade of severity.

If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

FAQs from users

What else is evaluated during the semen analysis besides the number and motility of spermatozoa?

By Marita Espejo Catena M.D., M.Sc., Ph.D. (gynecologist).

The semen analysis is a key study in the evaluation of a couple's infertility and is fundamental for defining the treatment that can help in achieving pregnancy.

The basic semen analysis (seminogram or spermogram) not only evaluates the number and motility of the spermatozoa but should also study the volume, color, liquefaction, viscosity, and pH of the seminal fluid, the presence of leukocytes in the ejaculate, or the morphology of the spermatozoa.

It should be understood that the seminal sample in an ejaculate not only contains cells from the testes but also fluid from the seminal vesicles and prostate and that alterations at these two levels can produce alterations in the physical and chemical characteristics of the sample.

One of the important aspects to evaluate in the basic semen analysis is the sperm morphology, that is, the appearance of the spermatozoa and, as a percentage, the number of cells that are abnormal. If this percentage is higher than 96%, which implies that there are less than 4% of normal cells, in the case of infertility, the recommended treatment is in vitro fertilization with sperm microinjection.

What happens if my sperm sample is rejected?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Sperm specimens that are rejected for any reason should be repeated three days after last ejaculation in order to respect the abstinence period.

Can having your phone in your pocket make you infertile?

By Sergio Rogel Cayetano M.D. (gynecologist).

Some scientific studies have suggested that the radio frequencies used by cell phones could have harmful effects on health, such as a decrease in sperm quantity and quality.

However, not all studies present the same results. This may be due to the presence of confounding factors, as for example has happened in the case of coffee, which has been associated in some studies with lung cancer.

The conclusion is that at present we cannot be certain that the use of cell phones affects sperm quality. However, there are studies that suggest it and it seems reasonable to recommend that patients who have sperm problems or who are going to undergo fertility treatment should, as far as possible, not abuse the use of these devices.

The results of my semen analysis are abnormal, what's next?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Your doctor will evaluate the results of the semen analysis along with other tests such as hormonal testing, anatomical evaluation, related conditions, genetic factors, medical history, etc.

Only by doing this, he or she will be able to identify the cause behind abnormal results and find the best possible solution or treatment. In case the results don't improve after repeating the semen analysis, it is likely that a fertility treatment is needed.

What causes round cells in sperm?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Sometimes, a macroscopic examination of a sperm specimen shows a high percentage of round cells in addition to sperms. Normally, they are just bladder, prostate or urethral epithelial cells, immature germ cells, or white blood cells (leukocytes).

The presence of leukocytes indicates the presence of an infection, which could lead to alterations in other parameters. In this case, the semen analysis would be repeated after treating the infection with antibiotics.

What may be the cause of incomplete seminal liquefaction?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

Incomplete liquefaction of semen may be caused by a lack of prostate enzymes. Liquefaction is the process by which semen becomes less viscous, i.e., it becomes more liquid in appearance. Liquefaction usually occurs after about 15-20 minutes.

An altered value of seminal liquefaction can affect the motility and concentration of spermatozoa, providing altered semen analysis results. Therefore, this alteration can cause problems in achieving pregnancy naturally.

Suggested for you

This post focuses on the interpretation of a semen analysis report. To learn how to prepare, how long you should abstain before a sperm analysis and more, read: What Is a Semen Analysis Report? – Purpose, Preparation & Cost.

Also, we have made several references to a condition called leukocytospermia or pyospermia, which is diagnosed when the presence of white blood cells is detected in a sperm sample. See this for more: Leukocytospermia or Pyospermia – Symptoms, Causes & Treatment.

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Authors and contributors

 Marita Espejo Catena
Marita Espejo Catena
M.D., M.Sc., Ph.D.
Graduated in Medicine and Surgery from the University of Valencia in 1992. Specialist in Gynaecology and Obstetrics. Doctor in Medicine from the University of Valencia in 2000. Master in Assisted Human Reproduction by the Rey Juan Carlos University and IVI in 2008. Currently, she is the director of Instituto FIVIR. More information about Marita Espejo Catena
License: 464616497
 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Sergio Rogel Cayetano
Sergio Rogel Cayetano
Bachelor's Degree in Medicine from the Miguel Hernández University of Elche. Specialist in Obstetrics & Gynecology via M. I. R. at Hospital General de Alicante. He become an expert in Reproductive Medicine by working at different clinics of Alicante and Murcia, in Spain, until he joined the medical team of IVF Spain back in 2011. More information about Sergio Rogel Cayetano
License: 03-0309100
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Sandra Fernández
Sandra Fernández
B.A., M.A.
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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