So, you’ve just received your semen analysis results, stared at a wall of numbers and medical jargon, and realised you have no idea what any of it actually means. Don’t worry, you’re not the first!
Medical reports are notoriously hard to read, littered with medical jargon that almost guarantees a panic-driven trip to "Dr Google." But a semen analysis report doesn't have to be a mystery nor is it a pass / fail test.
Let’s strip away the jargon, look at what those numbers mean, and break down what you should actually be looking for on your results page.
1. Concentration (How many)
When you ejaculate, you produce a mixture of sperm cells and seminal fluid. Your volume is the total amount of fluid produced (ideally 1.4 ml or greater).
Concentration measures how many million sperm cells are packed into each single millilitre of that fluid.
• The WHO lower refererence range: 16 million sperm per ml.
• Total sperm number: You might also see a figure called "Total Sperm Count." This is simply your concentration multiplied by your sample volume. The standard lower reference range here is 39 million sperm or more per total ejaculate.
2. Motility (How well they swim)
Sperm need to swim a remarkably long journey through the female reproductive tract to reach an egg. Motility describes whether sperm are moving. Progressive motility describes sperm that are moving forward effectively; total motility combines progressive and non-progressive movement.
On your report, motility is broken down into three categories:
• Progressive (PR): These sperm are swimming strongly and moving forward at a good speed.
• Non-Progressive (NP): Sperm are moving but not at a high speed
• Immotile (IM): Not moving at all.
According to the WHO parameters at least 30% of your sample should be progressively motile (or 42% total motile, combining progressive and non-progressive).
Note: Some lab reports break progressive motility down further into "rapid" and "slow" progressive. As long as the combined progressive number hits the target, you’re in good shape.
3. Morphology (The shape of the sperm)
This is the metric that causes the most unnecessary panic for men reading their results for the first time. Morphology simply refers to the physical size and shape of the sperm cell.
Testicles are remarkably high-volume factories, but their quality control isn't perfect. It is completely normal for a huge percentage of a man’s sperm to have bizarre shapes such as two heads, crooked tails, oversized caps, or blunt heads.
• The WHO lower reference range: 4% normal forms.
Decoding the medical jargon
If your results fall outside these baseline targets, your report might contain some intimidating medical terms. Here is what those words actually mean in plain English:
• Normozoospermia: Everything came back within normal reference ranges.
• Oligozoospermia: Sperm concentration or total count is lower than the recommended target.
• Asthenozoospermia: Sperm motility (swimming ability) is lower than the target.
• Teratozoospermia: Sperm morphology (shape) is below the 4% target.
• Oligoasthenoteratozoospermia (OAT): All three main metrics (count, movement, shape) are below baseline targets.
• Azoospermia: No sperm cells were detected in the ejaculate sample.
Other parameters on your report
Beyond the "big three," lab technicians evaluate several secondary factors that give a fuller picture of reproductive health:
• pH: Semen is normally alkaline. An elevated pH can occur with inflammation or infection, but pH alone cannot diagnose an infection and must be interpreted with the other findings.
• Liquefaction & viscosity: Semen normally liquefies after ejaculation. Delayed or incomplete liquefaction may be reported by the laboratory and is interpreted with viscosity and other findings.
• Debris & round cells (Leukocytes): Round cells can include immature germ cells and white blood cells. If leukocytes are increased, the laboratory may use additional methods to clarify the finding. Inflammation or infection may be considered in the appropriate clinical context.
• Agglutination: This describes sperm sticking together (head-to-head, tail-to-tail, or clumped). Agglutination can have several causes. Antisperm antibodies are only one possible explanation and are not routinely tested in every patient.
• White & red blood cells: Seeing blood cells listed can sound concerning, but it simply provides clinicians with useful diagnostic information. Elevated white blood cells (immune cells) or the presence of red blood cells can be due to a number of reasons and may be noted on your report so that a clinician can guide you further. In some instances the lab team will need to contact your GP to notify them of these findings.
So my results are out of range... What next?
If one or more of your metrics came back lower than the targets, here is how to approach your next steps logically:
Step 1: Don't rely on a single snapshot
A single semen sample is just a snapshot of a single day. Sperm parameters fluctuate constantly based on recent illnesses, stress, alcohol intake, heat exposure, or even how long you abstained before giving the sample. Medical guidelines almost always recommend repeating the test 8 to 12 weeks later before making any definitive diagnosis.
Step 2: Respect the 90-day lifecycle
Sperm take roughly 75 to 90 days to be produced, mature, and be ejaculated. That means the lifestyle changes you make today may take time to be reflected in a repeat analysis. Simple, consistent interventions around diet, hydration, sleep, heat management (ditching tight clothes and saunas), and targeted antioxidant supplementation can yield notable improvements on a repeat test.
Step 3: Speak to a specialist
If your results remain out of range after a repeat test, then it is recommended that you book a consultation with a specialist, ideally a Urologist or Andrologist with expertise in male fertility. A fertility specialist can decide whether further tests are appropriate based on your history and repeated semen results. These may include examination, hormone tests or other investigations such as Sperm DNA Fragmentation or a simple ultrasound. What's important to understand is that not everyone needs all the tests and it's about your personal history and situation.
Reviewed by: Shaun Rogers 28/09/26
Version 2.0
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