Producing a sample for a semen analysis is, for most men, the least dignified part of trying to have a child. Then a report arrives full of terms like motility, morphology and concentration, with some figures flagged as below reference range, and no explanation attached. Men frequently read that page alone, conclude the problem is entirely theirs, and say nothing about it for weeks.
It is worth stating plainly that male factors contribute to a large share of infertility — roughly comparable to female factors, and often both are present. Assessing the man is not an afterthought or an accusation; it is half the picture, and it is by far the simpler half to investigate. A semen analysis is inexpensive, non-invasive and highly informative, and it is where a fertility workup for a couple should begin rather than end.
What the Test Measures
The laboratory reports several separate things. Volume is how much fluid was produced, and a very low volume can point to a blockage, a problem with the seminal vesicles or prostate, or ejaculation backwards into the bladder. Concentration is how many sperm are present per unit of fluid, and total count combines that with volume. Motility describes what proportion are moving and how well — sperm that are present but not progressing forward cannot reach an egg. Morphology assesses the proportion with normal shape, judged against strict criteria, which is why the normal proportion is far lower than most men expect and a low figure is not automatically alarming.
The report also notes fluid characteristics such as how quickly the sample liquefies, its acidity, and whether white blood cells are present, which can suggest infection or inflammation. Where no sperm at all are found, the lab examines the spun sample specifically for small numbers, because the distinction between none and very few changes the entire approach.
Why One Result Is Not a Diagnosis
Semen quality varies substantially in the same man from week to week. A fever in the preceding couple of months can markedly depress a result, because sperm take approximately two to three months to develop — so a bad chest infection in April shows up in a June sample. Alcohol intake, poor sleep, significant stress, heat exposure from prolonged hot tub use or a heated seat, some medications, and the interval since last ejaculation all shift the figures.
For that reason an abnormal result is normally repeated, usually after a number of weeks, before conclusions are drawn. Collection matters too: follow the abstinence interval the laboratory specifies, keep the sample near body temperature, and get it to the lab within the window they give you. A result that is abnormal because the sample sat in a cold truck for an hour tells you nothing about fertility.
What Happens If It Is Genuinely Abnormal
The next step is a proper assessment rather than a supplement regimen. That means a history covering previous surgery, undescended testicles, infections, injuries, medication and anabolic steroid use — testosterone taken for physique or symptom reasons suppresses sperm production and is a common and reversible cause that men often do not think to mention. It means an examination of the testicles, looking in particular for a varicocele, which is a treatable cause. It usually means hormone bloodwork, and sometimes genetic testing where the count is extremely low or absent.
Plenty of causes are correctable. Others are not, but even where sperm production is severely impaired, sperm can often be retrieved directly and used in assisted reproduction. The outcome that should be avoided is a man reading a report on his own, assuming the situation is hopeless, and never following it up.
Dr. Raymond Nash provides male fertility assessment, semen analysis interpretation and treatment at Grande Prairie Men’s Medical Clinic. If you have results you do not understand, or have been trying without success, an appointment can be arranged at gpmm.clinic or (587) 416-8296. This article is general information and cannot substitute for review of your own results by a physician.