Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Since male factors contribute to infertility 50% of the time, testing his sperm can be an important piece of the puzzle if you’re trying to get pregnant. It can be daunting, though, if you don’t know what to expect (or why you might want to test in the first place).
There’s more than meets the eye when it comes to sperm testing and semen analysis, but we’re here to break it down! Read on to learn all about what semen analysis is, how to prepare, and what it will tell you.
What is Semen Analysis?
Semen analysis is the main testing that can be done for male fertility. Depending on if you’re having analysis done in a lab or with an at-home test, you may get information on different parameters. The main aspects that a test will look at are how many sperm there are, how well they’re moving, and if they’re normally shaped.
Semen analysis may be done once, or you may need to test multiple times over a few months to get a sense of how your semen parameters are changing (if you’re trying to improve sperm quality).
Preparing for the Test
To get the best and most accurate results from your semen analysis or sperm test kit, you’ll need to prepare a little bit. Follow these steps for the optimal semen analysis:
Abstain from Ejaculation for 2-5 Days Before the Test
Abstaining for 2 or more days will typically increase sperm count, helping to get a more accurate result. Longer than 5 days, though, can lead to a decrease in other parameters of sperm quality, since your body ideally needs to keep making and cycling through fresh sperm. So 2-5 days is the sweet spot for your semen analysis.
Avoid Substances that Can Affect Sperm Quality
You should try to avoid things that are bad for sperm quality in general when you’re trying for a baby, but especially within the 5 days before your semen analysis! Don’t drink alcohol, use marijuana or other drugs, or take unprescribed steroids or hormones. These can all affect your sperm parameters.
Inform Your Healthcare Provider About Ongoing Medical Conditions or Medications
Several medications or conditions may influence the results of your sperm test (and therefore also potentially fertility) and are worth a conversation! These include any recreational drugs, supplements or herbs, and all your prescription medications. Continue to follow your doctor’s advice regarding your medications, but ask abbott how they may affect your results.
How the Test is Performed & Why At-Home Tests are Helpful
When you go for a semen analysis, you’ll provide a sample by ejaculating privately at the clinic. If that isn’t an option for you, for religious or other reasons, chat with your doctor about other options they can provide.
With at-home sperm tests, you still need to get a sample without using lubricants, condoms, or a partner, but of course the process is more private! At home sperm tests can be more convenient, discreet, and don’t require an appointment or a referral. Depending on your insurance situation, they may also be less expensive.
Analysis of the Semen Sample
When the lab receives your sample, it will look at aspects of sperm quality, including:
- Sperm motility: if your sperm are moving at all, and if that movement is forward (progressive motility) or misdirected/in circles (non-progressive). Normal percentage of motile sperm is around 40%.
- Sperm morphology: This is basically whether your sperm looks “normal” under a microscope! Poorly shaped sperm may not be able to fertilize an egg, but luckily, anywhere from 4-10% normal morphology is considered typical.
- Sperm count: The overall concentration of sperm, and one of the most important numbers in male fertility. 15-200 million per milliliter is normal.
It will also test your semen (the substance surrounding and supporting sperm), looking for:
- Volume: are you ejaculating enough, in total? Between 1.5 and 5 mL is normal, and high or low volumes may indicate lower quality sperm.
- pH: Your semen isn’t too acidic or too basic for sperm to survive.
- Presence of immune cells: If there are white blood cells, anti-sperm antibodies, or other cells that might indicate infection or an autoimmune condition, it may impact fertility.
If you’re using an at home sperm test like the Proov Sperm Test, you’ll typically get more streamlined results like whether your Motile Sperm Concentration is low or normal. With the Proov Sperm Test, you’ll also get a YO Score comparing your specific results with those of other men who have fathered children. This may indicate if it might take you and your partner more or less time to get pregnant.
Understanding the Results
Doing your semen analysis may feel like only half the battle. When you get your results back, you might not know what to make of them, and that’s normal! It can be challenging to understand what all the numbers might mean for fertility, unless things are really black and white.
If there are no sperm in your sample at all, you may be diagnosed with azoospermia. This doesn’t mean you won’t be able to have children, but it does mean you’ll need additional follow-up testing to figure out why you have no sperm and potentially treat the causes.
If you have a sperm count below 20 million/mL, that’s known as oligospermia, and this will decrease your chances of conceiving (or it may take more time). If you fall into this category, you’ll likely want to do some follow-up testing and check out tips for improving sperm quality.
You may also receive information from your lab on other abnormal sperm parameters, and consult with your doctor about how they may impact your fertility. In general, abnormal parameters certainly don’t make it impossible for you to have a child, but may make it more challenging, take longer, or require assistance.
And if all your results are normal, congratulations! Your fertility is likely normal and conceiving may just be a matter of time, or related to female fertility. If you’ve been trying for over a year, your doctor may still want to probe further (into things like genetic contributions), but it’s likely that your sperm are just fine.
