After trying unsuccessfully to have a child, many couples are taken aback when they first seek medical treatment at fertility clinics. A veritable barrage of tests awaits, with unfamiliar terminology in the results. Breaking through the jargon and learning the science beneath can be helpful to understanding male infertility. 

What To Expect Before Your Fertility Test

At a fertility clinic, a thorough assessment can help to diagnose any medical reasons for male infertility. You’ll be asked to provide a complete medical history, discuss any medications or herbal supplements you’re currently taking, undergo a physical examination, and provide a semen sample. For best results, your male infertility doctor may ask you to avoid sexual activity for 2 to 5 days before you provide a semen sample, which increases the reliability of the test. However, it’s wise to engage in sexual activity (anything that results in ejaculation) within two weeks of the test, as periods of abstinence can artificially lower your sperm activity.

Interpreting the Test Results

The exact tests done in a semen analysis depend on the presenting concern and the judgment of your fertility doctor. However, common measures include:

  • Volume. This simple test assesses how much semen is produced in a single ejaculation. Too little (under 1.5 to 2 mL) may signal problems with the prostate or testes.
  • Sperm count. In the lab, the number of sperm — the moving reproductive cells in a semen sample — is assessed. Results are typically given in number of sperm per milliliter (mL) of semen. Typical results range from 20 to 40 million/mL.
  • Sperm motility. Simply put, motility refers to how effectively sperm cells can move forward, essential to the successful fertilization of an egg. For an average man, 61% of sperm will show forward movement. Numbers falling below 40% are on the lower end of normal.
  • Sperm morphology. This measurement refers to the percentage of sperm that have a normal shape. Sperm with an abnormal-sized head, two tails, or other structural differences may lower fertility.
  • Fructose level. The level of fructose in semen is a measurement of how healthy the seminal vesicles are. A typical value is greater than 3 mg/mL.
  • pH. Understanding the acidity or basicity of semen can help to diagnose common problems. A normal pH ranges from 7.1 to 8.0, with lower numbers indicating a more acidic sample. Acidic semen may result from blockage of the seminal vesicles, while basic (higher pH) semen may be caused by infection.

Each of these measures alone provides only a partial picture of male fertility. For example, a person could have a low overall sperm count but highly motile sperm that increase likelihood of fertility.

Source: Fertility Authority