“A good semen sample is necessary but not sufficient for male fertility.”

The manual provides reference limits for semen characteristics, but these values are not a fertility test on their own. Semen analysis findings should be interpreted together with clinical history and other investigations when evaluating male infertility.

The main test to check for low sperm count is a semen analysis test. This involves a sample of your semen being tested to check the amount of sperm in it. The test also checks how fast the sperm move and the shape of your sperm. If your semen analysis test results find a possible problem, you'll have another semen analysis test usually around 3 months after the first test.

The WHO sixth edition emphasizes that semen analysis reference limits are only statistical boundaries and do not by themselves diagnose fertility or infertility. A semen analysis result must be interpreted in the context of the couple’s full clinical evaluation and other factors.

Problems with the quantity or quality of your semen and sperm, such as low sperm count or sperm that don't move properly, can affect your sperm's ability to reach and fertilize an egg. Problems with your sperm's ability to fertilize an egg can cause infertility, which is the inability to conceive a baby after a year of trying. ... If your semen analysis results aren't all normal, it doesn't mean you're permanently infertile. But it does show that your sperm may be part of the reason you and your partner are having difficulties getting pregnant.

Semen analysis is recommended as a first-line investigation of the male partner, but clinicians should be aware of its limitations. The presence of normal semen parameters does not ensure normal fertility potential, and conversely, abnormal values do not necessarily imply sterility. Male fertility is a complex trait influenced by testicular function, endocrine regulation, genetic and epigenetic factors, sexual function, and the reproductive health of the female partner.

Semen analysis is the first step to identify male factor infertility. Standardized methods of semen analysis are available allowing accurate assessment of sperm number, motility and morphology. However, a semen analysis cannot measure all aspects of sperm function and therefore cannot conclusively predict fertility or infertility. Some men with semen parameters within the ‘normal’ range are infertile, while others with abnormal semen parameters are able to initiate pregnancies.

Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Male infertility is caused by deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. However, normal semen parameters do not guarantee fertility, and impaired semen quality does not always mean infertility.

Some health issues can have an impact on male fertility, including: diseases and conditions that affect the testicles; conditions that affect how sperm move; medical conditions that affect the hypothalamus or the pituitary gland. These glands send out hormones that cause the testicles to make testosterone and sperm. Some conditions can lower the amount of hormones the glands make. That then lowers the amount of testosterone and sperm in the body. Age also can play a role. Sperm's ability to move and the number of sperm that have a typical shape tend to go down with age, especially after age 50.

Semen analysis results… If you have a low sperm count, your semen contains fewer than 15 million sperm in each milliliter or less than 39 million sperm total for the entire sample. Many factors are involved in pregnancy. The number of sperm in the semen is only one. Many people with low sperm counts are able to get their partners pregnant. Likewise, some people with typical sperm counts are not able to start pregnancies.

Male infertility means you’re not able to have children with a fertile female partner, despite frequent, unprotected sexual intercourse. Many biological and environmental factors can cause male infertility. These include: sperm problems, including malformed sperm, low sperm count and low sperm movement; hormonal issues; ejaculation problems; genetic conditions; certain medications; and lifestyle or environmental factors. Sometimes, healthcare providers can’t determine the cause of male infertility, even after thorough testing.

Male infertility is a multifactorial condition and is estimated to affect 7% of all men. In approximately 30–40% of cases, the cause of male infertility remains unexplained, even after standard semen analysis and routine diagnostic workup. This indicates that normal semen parameters do not guarantee normal male fertility. Lifestyle factors such as obesity, cigarette smoking, alcohol intake, stress, and exposure to environmental toxins may affect sperm function and DNA integrity without always being reflected in basic semen parameters.

Semen analysis is the main test used to measure the quantity and quality of a man's semen and sperm. But it does not tell you everything about a man’s fertility. Some men with normal semen analyses may still be infertile, and some men with abnormal semen analyses can still father children. Hormones made by the pituitary gland tell the testicles to make sperm. Very low hormone levels cause poor sperm growth.

A semen analysis is the most important laboratory test of the male partner. However, a normal semen analysis does not prove that a man is fertile. Many men with normal semen parameters have infertility, and some men with abnormal semen parameters are still fertile. Male fertility depends on many factors, including the ability to have intercourse, appropriate hormone levels, and the functional capacity of sperm to fertilize an egg and support embryo development.

Secondary infertility affects about 11% of couples in the United States, with about one-third of all cases being male factor infertility… Even after successfully conceiving before, various factors can change over time and impact a man’s fertility, including: being 40 years or older, low sperm count or reduced semen quality, reduced testosterone levels, testicular varicocele, ejaculatory disorders, prostate enlargement or removal, medical conditions such as hypertension and diabetes, taking medications that affect sperm production, genetic conditions, [and] lifestyle factors such as weight gain, alcohol consumption, or smoking.

Modifiable lifestyle factors, such as elevated body mass index (BMI), tobacco and alcohol use, poor dietary patterns, physical inactivity, and exposure to environmental toxins, have been associated with impaired semen parameters and sperm DNA damage… These factors may negatively impact male fertility potential even when semen parameters are within reference ranges.

A semen analysis is usually the first male fertility evaluation we do in the fertility assessment process. This is the reason that we ask all of our patients to get at least two semen analyses. Most men with an abnormal semen analysis can father children with treatment.

Infertility is when a couple cannot get pregnant (conceive) despite having regular unprotected sex… In about a third of cases, infertility is due to problems with the man, such as poor-quality semen. In about a third of cases, it is due to problems with the woman, such as ovulation problems or damage to the fallopian tubes. In the remaining cases, there may be both male and female factors, or no identifiable cause (unexplained infertility).

Semen analysis is one of the first tests done to evaluate a man's fertility. It can help determine if a problem in sperm production or quality of the sperm is causing infertility. An abnormal result does not always mean there is a problem with a man's ability to have children.

A recent study states that average sperm counts have dropped by 59 percent over the past 38 years. With this drop in mind, it’s not surprising that the Centers for Disease Control and Prevention website states “in about 35 percent of couples with infertility, a male factor is identified along with a female factor.” Falling sperm counts, combined with the trend of having children at later ages, means that some couples will face difficulties with fertility. What we eat is always a culprit for any health problem. In the case of sperm, several studies concluded that excessive soy intake might decrease sperm concentration, while diets rich in fruits, vegetables and certain nuts have been associated with better sperm parameters.

Male infertility evaluation should begin with a semen analysis and a reproductive history. Normal semen analysis findings do not exclude male factor infertility, because fertility depends on multiple factors beyond the standard semen parameters.

According to the National Institutes of Health, a healthy ejaculation usually contains at least 39 million sperm, of which 58 percent or more should live. An abnormal result does not always mean infertility. However, if the sperm count is very low or very high, a man may be less fertile. The acidity of the semen and the presence of white blood cells can affect fertility.

There are many causes for male infertility, including abnormal semen and sperm production, failure of sperm delivery and general health and lifestyle issues. A normal sperm count is considered to be 20 million per milliliter of semen. Low sperm count, also known as oligospermia, is a very common cause of male factor infertility. Many factors including stress, smoking and drug use, obesity, nutritional deficiencies, hormonal problems, varicocele and genetic issues can affect male fertility.

The WHO semen manual provides reference limits for semen parameters, but clinicians emphasize that a normal semen analysis cannot by itself guarantee fertility. Male fertility also depends on sperm function, DNA integrity, timing, anatomy, endocrine factors, and the female partner's reproductive factors.

But even if all three measurements come back “normal,” that doesn’t always mean everything is working perfectly. In fact, some men who have trouble conceiving have semen analysis results that appear within the normal range. That’s because a standard test can’t detect every issue that might make it harder for sperm to fertilize an egg. A routine semen analysis doesn’t reveal whether sperm DNA is healthy… If the DNA inside the sperm is damaged… this damage can prevent the embryo from developing as it should.