Understanding Sperm Test Results

Find Out How The Results of Your Durham, NC Sperm Test Can Affect Male Infertility

The goal of sperm testing is to try to predict how sperm will behave in the female reproductive tract and when they meet eggs.

Our challenge is that semen testing is done in a plastic cup and on a glass slide in the absence of the female reproductive tract and eggs. We can measure the density of sperm, the volume of the ejaculate, the motility of the sperm, the morphology of the sperm, and a variety of other parameters related to infertility. There is an association between semen parameters and sperm function but it is far from perfect.

To interpret any laboratory test, it is important to understand how reliable the normal ranges are and use those as a baseline for potential infertility. When parameters don’t change much it is much easier to establish a normal range.

Unfortunately, semen parameters vary quite a bit from day to day depending on a number of variables. Sperm are produced in large groups within the testicles and they are transported and stored in a system of ducts. Along these ducts, there are several accessory glands that secrete fluid into the lumen where the sperm reside. When ejaculation occurs the ducts contract and eject the sperm and the fluid (semen) from the penis. If there are long intervals of time between ejaculations, sperm begin to die and the motility declines, possibly explaining infertility.

If men ejaculate frequently, there may be fewer sperm and ejaculate but the motility would be higher. To try to control these variables to some extent, we recommend that the semen analyses be performed two to seven days after the last ejaculation.

It is important to know that approximately 10 to 20 percent of semen analyses fall outside the normal range in men with low infertility, that is, normal fertility. It may be necessary to repeat a semen analysis if the parameters fall outside of the normal range. The farther the parameters fall for the normal range, the higher the probability that a problem with sperm function exists.

Sperm Density in Relation to Infertility 

Normal sperm density is defined as greater than 20 million sperm/milliliter. When the density falls between 10 – 20 million/milliliter there are probably some men with infertility problem but also many men with normal fertility. When the density falls below 10 million the chances that a problem exists are much higher and when the density is less than 1 million it is almost certain that male infertility problems exists.

Semen Volume

Normal semen volume is defined as greater than 2 milliliters. If the volume is low this could reflect an obstruction of the ducts, retrograde ejaculation (which means that some of the ejaculate goes into the man’s bladder), or not enough time has passed for the excess requirements to replenish the fluid in the ducts.

Sperm Motility

Normal sperm motility is defined as greater than 50 percent. When the motility falls between 25-50 percent on a single ejaculate, this may not reflect a problem. When the motility consistently falls below 25 percent, the chances of a problem are much higher. When the motility consistently falls below five to 10 percent, the chances that fertility is normal is highly unlikely.

Sperm Morphology

There are several different systems for measuring sperm morphology. The two most common systems are Kruger and the World Health Organization. Each system has its own normal range and it is best to have your doctor help you interpret these results.

When ejaculate does contain normal appearing sperm, the challenges of interpretation are similar to those in interpreting density and motility.

White Blood Cells

Too many white blood cells in ejaculate may indicate that the man has inflammation or infection of his genital tract, which may adversely affect sperm function.


Treatments based on the results on of this test include:

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