Male infertility contributes to about half of all cases of infertility and affects 7% of men. A semen assessment is one of the most important fertility investigations and provides valuable information about sperm health, helping guide further investigations and treatment recommendations.
Semen assessment is a laboratory test of a semen sample that evaluates several factors known to influence fertility. This includes:
The number of sperm present in a sample. A reduced sperm count or Oligozoospermia makes it less likely that sperm are able to fertilise an egg naturally through intercourse, and you may require IVF.
The ability of sperm to move effectively. Poor motility or Asthenozoospermia means sperm may struggle to reach the egg without medical intervention, and you may require ICSI.
The size and shape of sperm. This can impact the sperm’s ability to fertilise the egg.
Additional measurements that provide information about sperm production and the function of the male reproductive tract.
The results of a semen assessment can help identify potential male-factor fertility issues and guide recommendations regarding natural conception, further investigations, lifestyle optimisation or fertility treatment.
For the most accurate results, we recommend abstaining from ejaculation for between two and five days before producing your sample.
Samples can usually be produced either at the clinic or at home, provided they can be delivered to the laboratory within the required timeframe and in accordance with our collection instructions. Our team will advise you on the most appropriate method of collection.
Once received, the sample is analysed by our laboratory team and assessed against internationally recognised reference standards.
How should I prepare for the test, and what does the process involve?
Preparation is straightforward but important. You will be asked to abstain from ejaculation for between two and five days before producing your sample. Too short an abstinence period can result in a lower sperm count; too long can affect motility.
The sample is produced by masturbation, ideally at the clinic so it can be analysed promptly. Sperm parameters begin to change within an hour of ejaculation, so timing matters.
Before your appointment, let us know about any recent illness, particularly fever, as this can temporarily affect sperm parameters. Similarly, certain medications, recreational drugs, anabolic steroids, and significant lifestyle factors can all influence the results.
My results have come back abnormal. What does that mean for our chances?
An abnormal semen analysis result does not necessarily mean that natural conception is impossible.
Male fertility exists on a spectrum, and the significance of an abnormal result depends on which sperm parameters are affected and how severely. Some men with mildly abnormal results are still able to conceive naturally, whilst others may benefit from fertility treatment.
Because sperm quality can vary over time, an abnormal result will often need to be confirmed with a repeat semen analysis. This is usually performed several weeks later to allow sufficient time for sperm production and maturation, helping determine whether the findings are persistent or temporary.
If abnormalities are confirmed, the most appropriate treatment will depend on the specific findings and any other fertility factors affecting the couple. Options may range from continued attempts at natural conception to fertility treatment such as IVF with Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected directly into an egg to aid fertilisation.
Our specialists will explain what your results mean for your individual circumstances and discuss any further investigations or treatment options that may be appropriate.
What is ICSI, and when is it recommended based on semen assessment results?
Intracytoplasmic Sperm Injection (ICSI) is a specialised form of IVF in which a single sperm is selected and injected directly into an egg to achieve fertilisation. It was developed to help overcome male factor infertility and has significantly improved outcomes for many couples.
ICSI may be recommended when semen analysis shows a very low sperm count, poor sperm motility (movement), severely abnormal sperm morphology (shape), or when sperm has been surgically retrieved. It may also be advised following previous fertilisation failure or poor fertilisation rates during conventional IVF.
One of the advantages of ICSI is that it requires only a small number of viable sperm and can therefore be used successfully in many cases of severe male factor infertility.
ICSI is not always necessary when sperm parameters are only mildly reduced. In these situations, conventional IVF may still provide excellent fertilisation rates. The most appropriate fertilisation method will be discussed with you by your fertility specialist and embryology team based on your individual results.
Can sperm quality be improved before starting treatment?
Yes, and because sperm takes around two to three months to mature, changes made now can meaningfully affect the sample produced at the time of treatment. Sperm quality is more responsive to lifestyle changes than many people realise.
The factors with the strongest evidence include stopping smoking, which is associated with reduced sperm count, motility, and DNA integrity; reducing alcohol intake; maintaining a healthy weight; and avoiding excessive heat to the testes, including from hot baths, saunas, and tight clothing. Recreational drug use, including cannabis and anabolic steroids, can have a significant negative impact on sperm production.
Where a specific medical cause is identified, such as a hormonal imbalance or a varicocele, treating that underlying issue can lead to meaningful improvement.