One Plus One Plus One Plus One = Five: How to Analyze a Semen Analysis

When you think about it, men sort of have it easy. As women, we have to get poked and prodded, stabbed and jabbed, and pushed and pulled (all before 8AM) to figure out if things are working on our end. It’s about as easy as jumping on one foot while patting your head, rubbing your belly, and reciting the ABCs (backwards!). Sometimes, it’s just not easy being a girl! But even with all that we endure, it’s not uncommon to hear complaints from our significant others of the opposite sex when they are asked to provide a sperm sample. What we most commonly hear is, “Why do I have to do this anyway? What is it really going to show?”

Here’s the quick lowdown on what we are looking at with the sperm sample.

  1. Volume: The first parameter that is evaluated is the volume of the ejaculate (a.k.a. how much is in the cup). Normal volume is greater than or equal to 1.5mL.
  2. Concentration: Simply stated, how many sperm are there? By counting sperm, we are able to calculate the concentration. Normal concentration is greater than or equal to 15 million.
  3. Motility: While you may have sperm, can they swim? Sperm that just chill out are not going to get the job done! By assessing motility, you can answer this question. Normal motility is greater than or equal to 40%.
  4. Morphology: The last piece of the semen analysis involves analyzing each piece of the sperm (the head, the tail, and the middle). The percentage of normal sperm is calculated. Normal morphology is greater than or equal to 4%.

After all of the basic calculations have been completed, we are ready to get fancy. We plug the above values into a formula and by multiplying the volume by the concentration by the motility, we come up with parameter #5 = Total Motile Count (TMC). The TMC is important when deciding on how best to get the sperm to meet the egg. Above and below certain levels may mandate IVF vs. IUI or ICSI vs. insemination (for IVF).

Additionally, a borderline or failing grade on any, some, or all of the parameters will usually cost your guy a trip to the urologist. Abnormal semen analyses can be more than just markers of reproductive health but of overall health as well. Therefore, an abnormal semen analysis should always be repeated (this is not a one and done-type of situation) and never be ignored.