Semen Analysis Results Explained: What Each Number Means

A semen analysis report is a page of numbers with little explanation. This guide walks through each line using the reference values in the World Health Organization’s 2021 laboratory manual (the 6th edition) and the AUA/ASRM guideline on male infertility.¹⁵ It applies whether the analysis came from a clinic, a hospital lab or an at-home mail-in kit.

What are normal semen analysis results?

The WHO 2021 lower reference limits are the 5th percentile of results from men whose partners conceived within 12 months of trying, drawn from more than 3,500 men in 12 countries on five continents.²

Lower limits from Campbell et al. and Boitrelle et al.; medians from the WHO 6th edition centile table reproduced by Manchester University NHS Foundation Trust.²³⁴

“Lower reference limit” does not mean “cut-off for fertility”. The WHO 6th edition moved away from treating these values as thresholds, and the AUA/ASRM guideline says values above or below the limits do not by themselves predict fertility or infertility.³⁵ About 5% of fertile men in the reference group were below each limit by definition.

What each number means

Volume

The amount of fluid in the sample. If volume is low, first check that the whole sample went into the cup. With no sperm present, the AUA/ASRM guideline uses semen volume, pH and FSH to tell a blockage from a sperm production problem.⁵

Concentration and total count

Concentration is sperm per milliliter; total count is concentration multiplied by volume. Low concentration is called oligozoospermia, and no sperm at all is azoospermia. The AUA/ASRM guideline recommends karyotype testing for men with azoospermia or a concentration below 5 million per mL when it comes with a high FSH, small testes or a diagnosis of impaired sperm production.⁵

Motility

Total motility counts any movement; progressive motility counts sperm moving forward, which is what reaches the egg. Low motility is asthenozoospermia. Motility falls with time after collection: in a validation study of a mail-in kit it dropped about 0.39% per hour, which is why mail-in labs account for transit time.⁷

Morphology

Morphology is the share of sperm with a normal shape under strict criteria. A 4% result sits at the WHO lower limit; the median among fertile men was 14%.⁴ Low morphology alone is a weak predictor. The AUA/ASRM guideline notes that only rare patterns, such as complete globozoospermia, reliably indicate infertility on their own.⁵

Vitality, pH and other lines

Vitality is the share of live sperm. Many reports also list pH, round cells or white blood cells. The AUA/ASRM guideline recommends further evaluation if round cells are above 1 million per mL, and testing for infection when white blood cells (pyospermia) are present.⁵

How to read your result

1. Look at the pattern. The AUA/ASRM guideline says results matter most when several abnormalities are present, and semen parameters should be considered together, not one at a time.⁵
2. Repeat if abnormal. Semen parameters vary substantially from test to test, so at least two analyses a month apart are important to consider, especially if the first is abnormal.⁵
3. Check the collection. Follow the abstinence window your lab or kit gives; Legacy, for example, asks for 2 to 5 days.⁶ A spilled or late sample can skew results.
4. Take it to a clinician. Men with one or more abnormal parameters should be evaluated by a male reproductive expert with a full history and exam.⁵

What happens after an abnormal result?

The AUA/ASRM guideline recommends hormonal testing, including FSH and testosterone, for men with low libido, erectile problems, low or absent sperm, small testes or signs of a hormonal problem.⁵ Genetic tests are added for very low counts or azoospermia, and imaging is used selectively.⁵ It says clinicians should not order sperm DNA fragmentation testing in the initial evaluation.⁵

Some findings are treatable, such as a palpable varicocele or a hormone problem, and many couples with male factor infertility go on to IUI or IVF with ICSI. For IUI, the guideline notes a minimum of about 3 to 5 million motile sperm in the ejaculate is needed; below that, success falls.⁵ Read IUI vs IVF for the options.

Testosterone and supplements

The AUA/ASRM guideline is direct: clinicians should not prescribe exogenous testosterone to a man interested in current or future fertility, because it suppresses sperm production.⁵ If you are on testosterone or considering it, read TRT and fertility and talk to a urologist about fertility-preserving options.

The same guideline says the benefits of supplements such as antioxidants and vitamins for male fertility are of questionable clinical utility.⁵ If you want to try one, zinc and selenium for sperm covers the best-studied ingredients. Supplements are not reviewed by the FDA before sale.

At-home vs clinic semen analysis

Mail-in lab kits (Fellow, Legacy) report the full panel above; FDA-cleared home devices report fewer values. The AUA/ASRM guideline says there is no substitute for a specialized andrology lab for a comprehensive evaluation, and that each home test must be judged on its own accuracy.⁵ A home result is a good start and an easy way to get the male partner tested.

What you can do now

Sperm take roughly three months to develop, so lifestyle changes take time to show up in a repeat test. The 90-day sperm health plan and how to increase sperm count cover the habits with the best evidence. The Investigate hub explains the rest of the workup for both partners.