Short answer
For a semen analysis, avoid ejaculation for 2 to 7 days and give the whole sample at the lab. As per WHO, a sperm count of 16 million per mL or more, total motility of 42% or more and normal forms of 4% or more are in the expected range. One low report is not a final answer: the test is usually repeated after 2 to 3 months.
A semen analysis (sperm test) is the first and most useful test when a couple has trouble conceiving. In about half of couples, a male factor plays a part. This guide explains how to give a reliable sample, how to read the report, and when to see a urologist for male infertility treatment. It is written by Dr. Aditya P.S. Sengar, urologist and andrologist at Precision Urology Hospital, Lucknow.
How to prepare for the test
- Abstain from ejaculation for 2 to 7 days before the test. Fewer days can lower the count, and more days can lower motility.
- Collect the whole sample by masturbation into the sterile container from the lab. The first part has the most sperm, so tell the lab if any was lost.
- Do not use lubricant, oil, saliva or an ordinary condom. They can harm sperm.
- Collect the sample at the lab if you can. If you collect at home, keep the container close to body temperature and reach the lab within about 30 to 60 minutes.
- Tell the lab about recent fever or illness. A high fever in the past 2 to 3 months can lower the count for a while.
Normal values in the report
Labs compare your result with the World Health Organization (WHO) reference values (6th edition, 2021). These are the lower limits seen in fertile men, so values at or above them are in the expected range.
| Report item | WHO lower reference value |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration (count) | 16 million per mL |
| Total sperm number | 39 million per ejaculate |
| Total motility (progressive + non-progressive) | 42% |
| Progressive motility | 30% |
| Vitality (live sperm) | 54% |
| Normal forms (morphology) | 4% |
Also on the report:
- pH: usually 7.2 or more.
- Liquefaction time: semen normally turns liquid within 60 minutes.
- Pus cells (WBC): more than 1 million per mL can point to infection.
A value slightly below a limit does not mean you cannot father a child. Many men with low-normal values do, and some men with normal values still need help. The report is one part of the picture.
Common words on a semen report
| Term | Meaning |
|---|---|
| Normozoospermia | All main values in the expected range |
| Oligozoospermia (oligospermia) | Low sperm count |
| Asthenozoospermia | Low motility, sperm do not swim well |
| Teratozoospermia | Fewer normally shaped sperm |
| OAT | Low count, motility and shape together |
| Azoospermia | No sperm seen, even after spinning the sample |
| Leukocytospermia | High pus cells in semen |
If your report is not normal
- Repeat the test after 2 to 3 months. Sperm take about 2 to 3 months to form, so one report can be misleading.
- See a urologist (andrologist). An examination often finds the cause. A common one is a varicocele, which is swollen veins above the testis.
- Further tests if needed: hormone tests (FSH, LH, testosterone, prolactin), a scrotal Doppler ultrasound, and in some men sperm DNA, genetic or urine tests after ejaculation. Low hormone levels are covered on the hypogonadism page.
- Treatment depends on the cause. It can be medicines, treatment of infection, varicocele surgery, or sperm retrieval for azoospermia with assisted reproduction.
Lifestyle steps that help sperm
- Stop smoking, gutkha and tobacco, and limit alcohol.
- Keep a healthy weight and exercise regularly.
- Avoid heat around the testes: hot tubs, laptops on the lap, long hours of sitting in hot conditions.
- Do not take bodybuilding steroids or testosterone without a doctor's advice. They can stop sperm production.
If you are in Lucknow, you can bring your semen analysis report to the OPD, or send it on WhatsApp for a free first opinion.
Frequently asked questions
How many days of abstinence are needed before a semen analysis?
WHO advises 2 to 7 days without ejaculation. Try to keep the same number of days if the test is repeated, so the results can be compared.
What is a normal sperm count?
As per WHO 2021, a concentration of 16 million sperm per mL or more, or 39 million or more in the whole sample, is in the expected range.
Can a man with a low sperm count become a father?
Yes, many can. Treating causes such as varicocele, infection or hormone problems can improve the count. Assisted methods such as IUI, IVF or ICSI help when natural conception is not possible.
Is azoospermia curable?
It depends on the cause. When sperm are made but blocked, surgery or sperm retrieval often works. When sperm production is low, hormone treatment or sperm retrieval with ICSI may still allow a biological child.
Should the semen test be repeated?
Yes, if the first result is abnormal. Repeat it after 2 to 3 months, because sperm counts change from sample to sample.
Diagnosis and treatment: Male infertility in Lucknow · Send your report on WhatsApp for a free opinion
This guide gives general information and does not replace a consultation. In an emergency, go to the nearest hospital.
Book a consultation with Dr. Aditya P.S. Sengar
OPD Mon to Sat, 12:00 PM to 6:00 PM at Precision Urology Hospital. Book on WhatsApp and the team will confirm your time.
Send your report on WhatsApp for a free opinionPrecision Urology Hospital, 652B/37 Pratap Nagar, Tedhi Pulia Ring Road, Lucknow 226022. Get directions
