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Fertility basics

How to Read a Sperm Analysis Report Like a Pro

So you or your partner got a sperm analysis report, and now you want to know what it means: is he healthy? Will you be able to conceive naturally? When it comes to getting pregnant, dad and his sperm are half of the equation.

Global estimates suggest that male factor infertility is about as common as female factor infertility, so it’s important to consider male reproductive health when trying to conceive. This post will explain what sperm is, what to look for in semen analysis reports, and what helps make the best swimmers.

The basics of sperm production

Spermatogenesis is the biological process of sperm cell production. New sperm cells are produced continuously over the male life span, with millions made per day. These cells are made in the seminiferous tubule of the testes with the help of Sertoli cells. Semen is made in the seminal vesicles, and this fluid contains nutrients and sugars to protect sperm cells. The entire process of initial stem cell to fully mature cell takes about three months.

The final step for sperm to be fully capable of fertilizing the egg is a process called capacitation. This process happens in the female reproductive system, where vaginal fluids help change the structure of the head so that genetic information can transfer to the egg. These fluids also trigger a series of chemical changes in the tails so that they can be more active and swim better.

What’s important to know about capacitation is that this step takes about 7 hours. So, your best fertility odds are the day or two before ovulation to maximize the likelihood of capacitated sperm reaching the egg. Having sex during the day of ovulation limits the likelihood of completed capacitation, which then reduces the odds of fertilization.

When should he get a semen analysis report?

According to the American Pregnancy Association , if you and your partner have not been able to conceive within a year, both your fertility and your partner’s fertility should be tested. There are some advantages to testing your partner’s fertility first.

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A female fertility test can include blood tests, ultrasounds, and a hysterosalpingogram (HSG), and the process can be expensive, invasive, and take weeks before you and your doctor know the results.  Unlike fertility testing in women, fertility testing in men is relatively easy, fast, and inexpensive. So, it’s more practical to address male fertility first with a simple and routine semen analysis report, which usually takes about a week to process. But ultimately, the choice is up to you and your partner.

How do you read a sperm analysis report?

Here are the important metrics in a semen analysis report:

  • Ejaculate volume: Normal semen samples are between 1.5 – 5 milliliters. If the volume is low, then this can be indicative of problems with the seminal vesicles.
  • Count: Healthy sperm counts are at least 20 million per milliliter of sample. If counts are low, this can be indicative of problems with production in the seminiferous tubules, or a blockage in the ejaculation duct that prevents these cells from leaving.

It’s important to know that intense heat exposure, like having a fever, can temporarily but significantly reduce sperm counts. If he has recently been sick with a high fever, wait at least three months for a new round of development and then get a semen analysis report for accurate results.

  • Morphology (or shape): Errors in production can lead to morphology (or shape) defects, like two heads, two tails, or crooked tails. These defects are really common, but if there is an abnormally high level of sperm, this can interfere with fertilization.
  • Motility: At least 40% of a sample should have motile (or moving) sperm cells. If counts are normal but motility is low, then fertilizing the egg will still be challenging.

What can he do to help sperm production?

There are a few lifestyle changes that men can make to improve their sperm quality:

  • Folate: Folate and folic acid are an important part of women’s prenatal vitamins. Folate has also been linked to improved sperm quality. Eating a healthy diet with foods rich in folate (like leafy greens) or taking a supplement can help improve characteristics like protecting the fragile DNA inside the sperm head.
  • Antioxidants: There’s some evidence that reactive oxygen species (the thing that antioxidants protect you from) interfere with sperm motility. This is another reason that a healthy diet is important for male fertility.
  • Alcohol: There is some evidence that alcohol can increase morphology defects and reduce motility. Not all the scientific evidence agrees that alcohol definitively reduces sperm quality, and it’s possible that this effect is more detrimental depending on genetic and environmental influences (like diet).

Can he run out of sperm if we have sex frequently during the fertile window?

You and your partner may wonder how often should you have sex to get pregnant, and if sex too frequently depletes his sperm counts.

If his sperm counts are average, having sex every day of the fertile window increase the chances of fertilization. If his counts are on the lower end, then have sex every other day so that enough of his cells can build up per ejaculation and increases odds of fertilization. If his counts are high (more than 40 million cells per mL), then have sex as much as you want.

Aarthi Gobinath, PhD

Aarthi Gobinath earned her PhD in neuroscience from the University of British Columbia. Her research covers the ways that stress affects the male and female brain differently.

She tackled the issue of sex bias in research by looking at why standard treatments for depression don't always work in the case of postpartum depression. Her work has been covered by Vice and Massive Science.

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