The essentials

A semen analysis measures semen volume, sperm count, movement, vitality and shape. The limits on the report are the lowest 5% of results in men who fathered a child within a year: a value below them lowers the odds but does not diagnose infertility. An abnormal result is usually repeated.

How do I read my semen analysis results line by line?

Each line has its own lower limit, usually from the World Health Organization (WHO) manual, 6th edition (2021)[1]. Here is a fictitious report for a 34-year-old man trying to conceive for 14 months.

Fictitious example of a semen analysis report (United States format)
TestResultReference (lower limit)Flag
Abstinence3 days2-7 days-
Volume2.8 mL≥ 1.4 mL-
pH7.8≥ 7.2-
Sperm concentration11 million/mL≥ 16 million/mLL
Total sperm number31 million≥ 39 millionL
Progressive motility24%≥ 30%L
Total motility38%≥ 42%L
Vitality (live sperm)61%≥ 54%-
Normal forms5%≥ 4%-
Peroxidase-positive leukocytes0.4 million/mL< 1.0 million/mL-
  1. Abstinence: 2 to 7 days without ejaculation is the usual instruction[4]; the lab records it because it changes volume and count.
  2. Concentration and total number: concentration is sperm per milliliter; total number is concentration times volume (11 × 2.8 ≈ 31 million). Both are below the WHO limits of 16 million/mL and 39 million[2][3]: a low sperm count, or oligospermia[9].
  3. Motility: progressive sperm swim forward; total motility adds those moving in place. Both are under their limits[2].
  4. Vitality and normal forms: both are above their limits of 54% and 4%[2][3].
  5. Leukocytes: under 1 million white blood cells per mL is the expected result; more can point to an infection[4].
  6. Your laboratory's report prevails: some labs still print the older 2010 limits (1.5 mL, 15 million/mL, 40% total motility)[3][4].

Count, motility and shape make more sense next to your FSH or testosterone: BloodSense explains each line and helps you prepare questions for your doctor.

Get my semen analysis explained

What is a semen analysis used for?

The test has two main uses[4]:

  • Checking male fertility when a couple has been trying to conceive for 12 months without success. Men are the only cause or a contributing cause in about 40% of couples with infertility[9], so US guidelines ask for the male partner to be assessed too[6].
  • Confirming that a vasectomy worked, usually 8 to 16 weeks after surgery[4]. Other birth control can stop when one fresh sample shows no sperm, or 100,000 or fewer non-moving sperm per mL[7].

Men found to be infertile also have a higher risk of later health problems[6]. The test often goes with blood tests such as FSH levels and testosterone.

What are normal semen analysis values?

WHO 2021 lower limits: the 5th percentile of more than 3,500 men from twelve countries whose partner conceived within 12 months[2]. Million/mL is also written 106/mL.

Lower reference limits for semen (WHO 2021), with source per line
ParameterLower limitOlder limit (WHO 2010)Source
Semen volume1.4 mL1.5 mLWHO 2021 via Boitrelle[3]
Sperm concentration16 million/mL15 million/mLCampbell (WHO data)[2]
Total sperm number39 million per ejaculate39 millionWHO 2021 via Boitrelle[3]
Progressive motility30%32%Campbell[2]
Total motility42%40%Campbell[2]
Vitality54%58%WHO 2021 via Boitrelle[3]
Normal forms4%4%Campbell[2]
pH7.2 to 8.0-MedlinePlus[4]
Leukocytesunder 1 million/mL-MedlinePlus[4]
Liquefactionwithin 15-30 minutes-MedlinePlus[4]

These limits do not separate fertile from infertile men[2]. In a US study of 1,461 men, fertile and infertile men overlapped widely for count, motility and shape, and none was a strong predictor alone[5].

What does a low sperm count or poor motility mean?

Reports may add labels such as oligospermia (low count), azoospermia (no sperm)[9] or asthenozoospermia (low motility). The 2021 WHO manual dropped most of these words: a value under a limit is not a diagnosis on its own[3]. From the most frequent causes to the rarest:

  • Common An unrepresentative sample: short abstinence, part of the ejaculate missed, or a delay before analysis[4]. Results also vary between samples.
  • Common A recent fever: in healthy men, a fever during sperm production cut concentration by about a third in later samples[8].
  • Common Varicocele: enlarged scrotal veins warm the testicle; the most common cause of a low count, found in about 40% of men with fertility problems[9].
  • Possible Habits and weight: smoking, heavy alcohol, marijuana or cocaine, long exposure to heat and obesity[11]. See our page on body mass index.
  • Possible Medicines and hormones: anabolic steroids, sulfasalazine and chemotherapy can lower sperm production[10].
  • Possible A hormone problem: low testosterone (hypogonadism), high prolactin, thyroid problems or uncontrolled diabetes[9][11]. LH and FSH help tell a testicle problem from a pituitary one.
  • Possible A past or current infection: testicle swelling from mumps, gonorrhea or chlamydia[9]. More than 1 million leukocytes/mL may be a sign of infection[4]; see prostatitis.
  • Rare Genetic causes: Klinefelter syndrome and other chromosome defects[9], or cystic fibrosis[4].
  • Rare A blockage or semen going the wrong way: problems carrying sperm out cause 10% to 20% of male infertility[9]; semen can also flow back into the bladder (retrograde ejaculation)[11]. A complete lack of sperm explains about 15% of male infertility[9].

Next steps: a repeat analysis, an exam, hormone blood tests, sometimes an ultrasound[4].

What can affect a semen analysis before the test?

No fasting is needed. Before giving your sample, check:

  • No ejaculation for 2 to 7 days before, as your lab asks[4].
  • No lubricant or saliva: both can harm sperm[4].
  • Collect the whole ejaculate, and tell the lab if any was lost[4].
  • Collected at home? Bring it to the lab within an hour, at the temperature your lab asks for[4].
  • Mention any recent fever[8] and any testosterone, anabolic steroid or other medicine[10].

When should I see a doctor about my semen analysis?

When to see a doctor

  • Emergency: call 911 or go to the emergency room for sudden, severe testicle pain, pain with nausea or vomiting, or pain or swelling that lasts more than an hour after an injury to the scrotum[12].
  • Within 24 to 48 hours, sooner if it gets worse, for a fever with a warm, red or tender scrotum, a lump in the scrotum, or recent contact with someone who has mumps[12].
  • At your next appointment for a value below the limits, no sperm, sperm still present after a vasectomy, or 12 months of trying without pregnancy[4].

Questions to ask your doctor

  1. Which limits did my lab use, the 2010 or the 2021 WHO values?
  2. When should I repeat the test, and how far apart?
  3. Should I have FSH, LH and testosterone blood tests, or an exam for a varicocele?
  4. Could any of my medicines or supplements lower my sperm count?

Frequently asked questions

What sperm count do you need to get pregnant?

There is no single number. Men below the WHO limits do father children, and men above them can still be infertile[5]. Count, motility and shape are read together, with your partner's evaluation.

Does testosterone therapy affect a semen analysis?

It can. Long-term misuse of anabolic steroids reduces sperm count and motility[10]. If you take testosterone or any steroid, tell your doctor before the test: it changes how the result is read.

Is "no sperm seen" after a vasectomy the final result?

One fresh sample with no sperm, or with 100,000 or fewer non-moving sperm per mL, is enough to stop other birth control[7]. If sperm are still found, the test is repeated until the sample is clear[4].

References

  1. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: WHO; 2021. who.int (accessed November 13, 2026)
  2. Campbell MJ, Lotti F, Baldi E, et al. Distribution of semen examination results 2020 - A follow up of data collated for the WHO semen analysis manual 2010. Andrology. 2021;9(3):817-822. doi:10.1111/andr.12983 (accessed November 13, 2026)
  3. Boitrelle F, Shah R, Saleh R, et al. The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis. Life (Basel). 2021;11(12):1368. doi:10.3390/life11121368 (accessed November 13, 2026)
  4. MedlinePlus. Semen Analysis. US National Library of Medicine. medlineplus.gov (accessed November 13, 2026)
  5. Guzick DS, Overstreet JW, Factor-Litvak P, et al. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med. 2001;345(19):1388-1393. doi:10.1056/NEJMoa003005 (accessed November 13, 2026)
  6. Schlegel PN, Sigman M, Collura B, et al. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline Part I. J Urol. 2021;205(1):36-43. doi:10.1097/JU.0000000000001521 (accessed November 13, 2026)
  7. Sharlip ID, Belker AM, Honig S, et al. Vasectomy: AUA guideline. J Urol. 2012;188(6 Suppl):2482-2491. doi:10.1016/j.juro.2012.09.080 (accessed November 13, 2026)
  8. Carlsen E, Andersson AM, Petersen JH, Skakkebaek NE. History of febrile illness and variation in semen quality. Hum Reprod. 2003;18(10):2089-2092. doi:10.1093/humrep/deg412 (accessed November 13, 2026)
  9. Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are some possible causes of male infertility? nichd.nih.gov (accessed November 13, 2026)
  10. NHS. Infertility: causes. nhs.uk (accessed November 13, 2026)
  11. MedlinePlus. Infertility. Medical Encyclopedia. US National Library of Medicine. medlineplus.gov (accessed November 13, 2026)
  12. MedlinePlus. Testicle pain. Medical Encyclopedia. US National Library of Medicine. medlineplus.gov (accessed November 13, 2026)

This page gives general information about semen analysis. It does not replace the advice of a doctor who knows your history and your partner's evaluation.