Semen Analysis

What is a semen analysis, and how to interpret the semen analysis?

Today, several reasons are linked to a decline in male fertility worldwide, and every day we come across more research about infertility in males. At IVF Turkey, we are very aware of the importance of the malefactor and the support they need during the fertility journey. With this aim, our team always answers questions about the malefactor. One of the most asked questions from our patients regarding male fertility is how to interpret the semen analysis; in other words, sperm count.

First, let’s start with a simple definition of a semen analysis:

To assess male fertility, a semen analysis is performed before an IVF treatment.

This test is vital to determine the reasons behind the fertility problems for couples trying to conceive naturally. Once the semen sample has been provided, it will be examined under a microscope to check the numbers of sperm, if they are healthy, and move correctly. A specific embryology laboratory is designed to perform this test.

We are very aware that providing a semen sample can be uncomfortable for most men. With this in mind, we do collaborate with very professional clinics and laboratory in London and also in Birmingham, if you would like to find out about having your semen analysis in of these clinics, here is Doctors Laboratory in London and Cherish-UK in London.

If you come to Istanbul for the whole treatment, we would like to reassure you that all our team members at IVF Turkey will ensure that this process will not add any additional stress to your treatment.

 What are the parameters of a semen analysis?

 When it comes to routine sperm test parameters, three parameters are considered the key ones: motility, count, morphology.

Let’s have a closer look at what these terms mean actually:

Motility: Sperm motility refers to the fluid ability to move with forwarding progressions and check how sperm can swim to fertilize an egg. According to WHO guidelines, it needs to be 32% progressive.

Count: The count refers to a measure of the number of sperms in the sample. A normal sperm count is considered as having at least 15 million sperm per milliliter of semen.

Morphology: The morphology refers to the shape of the sperm. According to the World Health Organisation (WHO) Criteria, a normal sperm should have an oval head-sized.

Although each parameter’s definition may seem straightforward, the evolution of each of them may sound complicated for many patients. In most of the clinics, the semen samples that are analyzed need to be according to the most recent World Health Organization report in 2010.

Please note that two criteria are mainly used regarding the morphology (shape of the sperm), the World Health Organisation, and Kruger Strict Morphology. According to WHO, the normal morphology is considered as having greater than %30. For Kruger, Strict criteria refers to having greater than 15% normal morphology.

We want to underline the fact that the result form content may vary from one clinic to another clinic even though they follow the WHO guidelines; for example, some of the clinics are using the Grading system to evaluate the motility of the sperm count:


Grading System:

Grading A:  Sperm with progressive motility. They are the strongest and swim fast in a straight line. (Motility IV)

Grade B: Sperm move forward but tend to travel in a curved or crooked motion (Non-Linear Motility) (Motility III)

Grade C: Non-progressive motility. Sperm do not move forward even though they move their tail (Motility III)

Grade D: Sperm are immotile and fail to move at all. (Motility I)

Grade E: Azoospermia (No sperm count)

According to the WHO, we want to share with you the table below, which indicates the reference values for human semen characteristics.

What do results mean? To be able to explain to you in more details, we would like to use the terms below with a definition for each terminology:

Normospermia: It is explained as sperms are normal in number, movement, and shape.

Aspermia: It can be described as a complete absence of semen.

Azoospermia: it is a condition when there is no sperm in the ejaculate.

Oligospermia: it is described as having a low sperm count.

Severe Oligospermia: This issue is characterized by having sperm counts that fall

between 0 and 5 million sperm/mL.

Asthenozoospermia: it is described as reduced motility of sperms in the sample.

Teratozoospermia: it can be described as an increase in the concentration of abnormal sperms in a sperm sample.

Polyspermy: it means a condition where the egg has been fertilized by more than one sperm nucleus.

Hypothermia: it is a condition when a man produces a sperm sample, ejaculates a sperm sample less than 1.5mL

Oligoastenozoospermia: It can be explained as a mixture of abnormal sperm shape, low sperm count, and a poor movement of sperm.

Oligoteratozoospermia: This condition refers to having both low sperm motility and reduced sperm.

Oligoasthenoteratospermia: It is called (OAT) which combines three different disorders; sperm motility, sperm morphology, and sperm count,

Hematospermia: It is a condition when blood is found in ejaculation.

Necrospermia (or necrozoospermia): This term can be described as a very high percentage of immotile spermatozoa in the ejaculated semen.

Among these results as above, the Azoospermia condition is the one that we come across often.  Many reasons can cause azoospermia condition, and the result is that the men have no sperms in the ejaculate. The best technique to solve this problem is micro testicular sperm extraction (micro TESE). The urologist and embryologist do the operation at the same time. The sperm is produced in the testicles. The urologist analyses the layers of the testicles to find sperm under local anesthesia. The urologist and the embryologist’s experience and their work harmony are essential to retrieve the sperm microsurgically.

IVF Turkey, an advanced center for this procedure. IVF Turkey did hundreds of micro TESE procedures, and success rates are at %60. Therefore, we advise men to try this technique before leading to other methods for child wish.

In conclusion, we would like to inform you that male fertility problems are very common as much as the female factors during the fertility journey. At IVF Turkey, we will design a personalized treatment that would be the best option for you.