A semen analysis is a lab report, not a verdict on masculinity. The NHS infertility diagnosis page lists it as the main male test: sperm count, and whether sperm are moving properly, plus a chlamydia urine test. Labs compare the result against World Health Organization reference values. Those numbers changed when the WHO manual was updated. If your printout still quotes β15 million/ml and 40% motilityβ from an older leaflet, you are reading last decade's reference sheet.
Both partners should be in the GP appointment. Male factor is involved in about half of fertility challenges β longer physiology in the male fertility and sperm health guide. This page is the report.
The numbers labs use
βReferenceβ means the lower fifth percentile of fertile men in the WHO datasets, not a target, not a guarantee, and not a personality score. The ranges are only valid for WHO-method tests.
| Parameter | Reference (lower limit) | In clinic English |
|---|---|---|
| Semen volume | 1.4 ml or more | How much was produced |
| pH | 7.2 or more | How alkaline the fluid is |
| Sperm concentration | 16 million per ml or more | How many in each millilitre |
| Total sperm number | 39 million per ejaculate or more | Concentration Γ volume |
| Total motility | 42% or more motile | Any movement |
| Progressive motility | 30% or more | Swimming forward, which is the useful kind |
| Vitality | 54% or more live | Alive, even if not swimming well |
| Normal morphology | 4% or more normal forms | Shape; 4% sounds low because the bar is strict |
A result under a line is a flag for a repeat test, not a diagnosis of infertility on its own. If the first analysis is abnormal, you should get a confirmatory test β ideally three months later so a full sperm-production cycle can finish; sooner if the first result is azoospermia or very few sperm. Two odd results, not one hungover sample, is the pattern that should change the plan.
How not to sabotage the sample
Follow the lab's leaflet. Typical UK instructions: two to seven days of abstinence, no lubricant unless they named one, complete sample into the pot, keep it warm, get it to the lab within the hour they specify. A partial sample, a long commute in a cold bag, or a fever two weeks ago will move numbers. Tell the andrologist. Don't interpret a bad first result in the car park with a protein-powder advert.
Don't routinely test antisperm antibodies. Don't add sperm DNA fragmentation testing as a hobby β UK fertility guidance says not to. Private add-ons are still add-ons. If two analyses are abnormal, a physical examination of the scrotum and testes, and consideration of testosterone and gonadotrophin bloods, is a clinician's job, not a supplement protocol.
What the numbers are not
They are not a fertility percentage. Couples conceive with βlowβ morphology and do not conceive with textbook counts. They are not a reason to skip her investigations. The NIH selenium fact sheet is a useful overlay. Selenium contributes to normal spermatogenesis.
Lifestyle that does get a mention for semen quality: excessive alcohol is detrimental; drinking within the Chief Medical Officers' 14 units a week, spread over several days, is unlikely to affect semen quality. Smoking is associated with reduced semen quality. BMI of 30 or over increases the risk of reduced fertility. Tight underwear and scrotal heat: association with reduced semen quality, uncertain whether loose boxer shorts fix fertility.
After the report
- Normal first test: you still complete her work-up. A good semen analysis does not explain absent periods.
- Abnormal first test: wait for the confirmatory sample unless the lab or GP has flagged azoospermia and wants it repeated immediately.
- Two abnormal tests: examination and, if offered, hormones. Referral is a GP/ICB conversation, not a coupon code.
- The 74-day production cycle is why three months is the honest window for any lifestyle change, including a food supplement.
A formula in that window is optional nutrition while you wait for a repeat sample. Zinc contributes to normal fertility and reproduction. Selenium contributes to normal spermatogenesis.
FAQ
My morphology is 3%. Is that why we are not pregnant?
It is below the 4% WHO line. It is one parameter. Repeat the test. Don't start ICSI in your head from a single number.
Can I retest in two weeks if I βate betterβ?
The default repeat is three months, unless the first result was a gross deficiency. Two weeks measures noise.
Should I add a DNA fragmentation test?
UK fertility guidance says do not carry out testing for sperm DNA integrity. If a private clinic sells one, ask them which guideline they are using.
Get the sample in properly. Repeat it if it is odd. Then decide whether a 90-day food supplement belongs beside the GP pathway β
How Him Fertility fits
A semen analysis is a lab report, not a shopping list. If you and a clinician are using nutrition in the ~90 days before a repeat test, Him Fertility is the menβs preconception formula in this range: zinc 15 mg (fertility, reproduction and testosterone maintenance), selenium 200 Β΅g (spermatogenesis), CoQ10 300 mg, ALCAR 250 mg, and KSM-66 ashwagandha. Research has reported sperm-count improvements in men taking ashwagandha. It does not replace a urology referral if two samples are abnormal. Pair it with Her Fertility via the couple bundle if you are both in a TTC window. Longer physiology: the male fertility and sperm health guide.
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