When a couple has been trying for a baby without success, the woman is often the first, and sometimes the only, person to be tested. That is a mistake. Male factors play a part in a large share of couples who struggle to conceive, and the key test for men is simple, quick and non-invasive. Testing both partners from the start saves months of worry and avoids putting one person through tests they may not need.
When a couple should get checked
- After 12 months of regular unprotected intercourse without pregnancy
- After 6 months if the woman is 35 or older
- Sooner if either partner has a known issue: irregular periods, past pelvic infection, previous testicular surgery or injury, undescended testis, mumps affecting the testes, or cancer treatment
- Sooner if there are problems with erection or ejaculation
What a semen analysis measures
A semen analysis looks at the sample under a microscope and measures several things at once. Each tells the doctor something different:
- Volume: how much semen is produced
- Concentration and total count: how many sperm there are
- Motility: how many sperm are moving, and how many are moving forward (progressive motility)
- Morphology: the proportion of sperm with a normal shape
- Vitality: how many sperm are alive, checked when motility is low
- Other signs such as white cells, which can point to infection
Understanding the reference values
The World Health Organization (WHO) publishes lower reference limits based on men who fathered a child within a year. The current (6th edition, 2021) values are:
| Measure | WHO lower reference limit |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration | 16 million per mL |
| Total sperm number | 39 million per ejaculate |
| Total motility | 42% |
| Progressive motility | 30% |
| Normal forms (morphology) | 4% |
These are not pass-or-fail cut-offs. Results slightly below them do not mean a man cannot father a child, and results above them do not guarantee fertility. They guide the doctor on whether further tests are needed and which treatment options make sense for the couple.
How to prepare for the test
- Avoid ejaculation for 2 to 7 days before the test, as the lab advises
- The sample is collected by masturbation into a sterile container provided by the lab, ideally at the lab itself
- Do not use lubricants or condoms for collection, as many affect sperm
- If collecting at home, keep the sample close to body temperature and deliver it within about an hour
- Tell the lab about any fever or illness in the past three months, as it can temporarily lower counts
Sperm take roughly two to three months to develop, so a single abnormal result is usually repeated after a few weeks before any conclusions are drawn.
Common causes of low sperm quality
- Smoking, heavy alcohol use and recreational drugs
- Excess heat to the testes: laptops on the lap, tight underwear, frequent hot tubs or saunas
- Excess weight, diabetes and poorly controlled health conditions
- Testosterone or anabolic steroid use, including some gym supplements, which can switch off sperm production
- A varicocele (enlarged veins in the scrotum)
- Past infections, including some sexually transmitted infections
- Certain medicines, and hormonal or genetic conditions
What can help
Many causes can be improved. Stopping smoking, reducing alcohol, reaching a healthier weight, avoiding heat exposure and stopping steroid or testosterone supplements can improve sperm quality within a few months. Infections can be treated. Some men are referred to a urologist or andrologist for an examination, hormone tests or ultrasound, and some couples are guided towards assisted reproduction such as IUI or IVF when that gives them the best chance. No test or treatment can guarantee a pregnancy, but a clear diagnosis for both partners lets you choose the right path early.
Getting started at the clinic
Our infertility specialist evaluates couples together, arranges the semen analysis alongside the woman's tests such as follicular monitoring, and coordinates referrals when needed. Consultations are private and confidential. Book a visit or call +91 70287 22200, open all 7 days in Viman Nagar.
