Semen analysis is the main test of male fertility: it assesses ejaculate volume and sperm concentration, motility and morphology according to WHO standards. The sample is given after 2–7 days of abstinence, with no alcohol and no overheating beforehand. One abnormal result is not enough — with poor numbers the test is always repeated in 2–4 weeks.
When a semen analysis is ordered
The main reason is planning a child: it is recommended to include semen analysis in a couple's work-up even before a year of trying, because the male factor is found faster and more cheaply than the female one. The test is a must when there is no pregnancy after 12 months of regular intercourse without contraception (6 months if the partner is over 35). It is also done after surgery on the scrotum (varicocele, inguinal hernia), after infections complicated by testicular involvement, to check results after infertility treatment and before sperm cryopreservation — for example, before chemotherapy.
How to prepare: the rules the result depends on
Preparation affects a semen analysis more than any other test. Abstinence — 2–7 days: fewer than two days lowers volume and concentration, more than seven worsens motility and raises the share of dead cells. The optimum for most laboratories is 3–4 days. Alcohol is excluded for 3–5 days and the sauna, steam room and hot baths for a week: overheating the scrotum suppresses sperm production, and the effect lasts for weeks. An acute illness with fever distorts the result for up to 2–3 months — exactly how long the full sperm maturation cycle takes — so after a severe respiratory infection the test is postponed.
How the sample is given
The sample is obtained by masturbation at the laboratory itself — separate rooms are equipped for this. The whole portion is collected into a sterile container: losing the first fraction distorts the assessment, because it contains the most sperm. Condoms and withdrawal are not suitable — lubricant and contact with skin change the parameters. If giving the sample at the clinic is psychologically impossible, collection at home is acceptable, but the container must be delivered within 30–60 minutes and kept at body temperature. Before the visit, check the hours for semen analysis: many laboratories accept samples only in the morning and early afternoon.
What the report shows: the main parameters
The laboratory assesses the ejaculate against WHO criteria (6th edition of the manual). The key rows are: volume (lower reference limit 1.4 mL), sperm concentration (from 16 million/mL), total motility (from 42%) and progressive motility (from 30%), the share of live cells (from 54%), and normal forms by Kruger (from 4%). Viscosity, liquefaction time and white blood cells are reported separately — an excess of white cells suggests inflammation. It is important to understand that the WHO values are not a “pass mark for fatherhood” but the 5th percentile of fertile men; values close to the limit are interpreted only by a doctor together with the history.
If the result is poor: the right order of steps
The first step is to repeat the test in 2–4 weeks with perfect preparation: the spread between two samples from the same man reaches tens of percent, and no diagnosis is made from a single report. If the deviation is confirmed, the work-up continues along several lines: hormones (testosterone, FSH, LH, prolactin), scrotal ultrasound with Doppler for varicocele, infection tests, and with a marked drop in concentration — genetics. Most causes — varicocele, inflammation, hormonal shifts — can be corrected, and the result is checked with a new semen analysis no earlier than 2–3 months later: the maturation cycle will not renew sooner.
What is added to a basic semen analysis
When the basic parameters are not enough, laboratories offer three extensions. The MAR test detects anti-sperm antibodies — an immune factor in which motile sperm “stick together” and do not reach the egg. The DNA fragmentation test shows the integrity of the genetic material: it is ordered when the partner has recurrent miscarriage or IVF attempts have failed, even if the routine semen analysis is normal. A semen culture looks for infection when white blood cells are raised. Ask about them in advance — some tests are done from the same sample, and you will not need to give another one.
How to read the abbreviations in the conclusion
At the end of the report the laboratory often writes a summary term. Normozoospermia — all parameters within the reference ranges. Oligozoospermia — few cells by concentration, asthenozoospermia — poor motility, teratozoospermia — few normal forms. The prefixes combine: “oligo-astheno-teratozoospermia” means a deviation in three rows at once. This describes the picture rather than delivering a verdict: behind the term there is always a cause that is investigated further, and the treatment depends on it.
- Abstinence 2–7 days, ideally 3–4
- No alcohol for 3–5 days, no sauna for a week
- Give the sample at the laboratory, the whole portion into the container
- WHO values: concentration ≥16 million/mL, motility ≥42%
- Poor result = repeat in 2–4 weeks
- Follow-up after treatment — after 2–3 months
Have your semen analysis report?
Upload the PDF semen analysis report to MedProtect — the app will break down each parameter: where the WHO value lies, what a deviation means and what to ask the andrologist.
Frequently asked questions
How should I prepare for a semen analysis?
Abstinence for 2–7 days (ideally 3–4), no alcohol for 3–5 days, no sauna or overheating for a week. The sample is collected by masturbation into a sterile container — completely, as the first portion is especially important for the assessment.
Can a semen sample be collected at home?
The sample can be collected at home, but it must reach the laboratory within 30–60 minutes and be kept warm (at body temperature). It is simpler and more reliable to give it at the laboratory itself — there are dedicated rooms for this.
What if the values are below normal?
Do not panic, and repeat the test in 2–4 weeks with proper preparation: semen parameters vary a lot from sample to sample. A diagnosis is made on at least two results. The next step is a consultation with a urologist or andrologist.
Do I need a doctor's referral?
No, a semen analysis can be done on your own without a referral. But if a doctor ordered it, ask whether additional tests are needed — a MAR test or sperm DNA fragmentation — so everything is done in one visit.
How long does the result take?
A basic semen analysis is usually ready the same day or the next working day. Additional tests (MAR, DNA fragmentation) can take up to 3–5 days.
Sources
- WHO laboratory manual for the examination and processing of human semen, 6th edition — 2021 (checked 15.09.2026)
- Clinical guidelines “Male infertility” — Russian Ministry of Health, 2025 (in Russian; checked 15.09.2026)