What Is Sperm Health and Semen Analysis?

What sperm and semen are

A sperm cell is the male reproductive cell, known in medicine as a spermatozoon. It has three parts: a head, a midpiece and a tail. The head carries the genetic material, the midpiece produces the energy needed for movement, and the tail propels the cell forward.

Production takes place in the fine channels of the testicles called the seminiferous tubules. From the first division to a mature cell, the process takes roughly 64 to 74 days; the cell then acquires its ability to move in a coiled duct known as the epididymis. This long cycle also explains why a change relevant to sperm health shows up in test results only months later: the mark left by a feverish illness or by intense heat exposure today may appear in an analysis two or three months from now.

Semen is not made up of sperm cells alone. During ejaculation the cells mix with fluid from glands such as the seminal vesicles and the prostate. This fluid carries and nourishes the cells and protects them against the acidic environment of the urinary tract. Most of the volume comes from the glands; the cells make up only a very small part of it.

What a semen analysis measures

A semen analysis, also called a spermiogram, is a laboratory examination. It is regarded as the first step in assessing male reproductive health. The sample is usually produced in a dedicated room at the laboratory; because a long delay can make the motility measurement misleading, the sample is examined shortly after it is given. A period of 2 to 7 days of sexual abstinence is generally requested beforehand; a period that is much shorter or much longer may change the result.

The main values reported are:

• Volume: the amount of semen produced, in millilitres.
• Concentration: the number of sperm cells per millilitre.
• Total number: the number of cells in the whole sample.
• Motility: the proportion of moving cells and how many of them travel forward.
• Morphology: the percentage of cells with the expected shape.
• Vitality: the proportion of living cells.
• pH and appearance: the acidity of the sample, the time it takes to liquefy and the presence of inflammatory cells.

The reference values on the report are lower limits derived from measurements made by the World Health Organization in a large group. Falling below these limits is not in itself a definitive conclusion, and being above them is not in itself a guarantee. Values differ markedly from person to person and, in the same person, from sample to sample; for this reason doctors do not decide on the basis of a single result and usually request a second examination a few weeks later. The result is interpreted together with the person's history and physical examination.

A semen analysis is not a diagnostic tool on its own; it is the first link in assessing male reproductive health. Where the doctor considers it necessary, hormone tests, an ultrasound scan of the testicles, urine and infection tests or genetic investigations may be requested. Home test kits mostly give only a rough indication of cell density; they do not measure values such as motility, shape and vitality, and therefore do not replace a laboratory examination.

Factors that affect sperm health

Heat. The testicles work at a temperature slightly below that of the body. Long hot baths, frequent sauna use, holding a laptop on the lap for long periods and working in hot environments are among the topics studied for their effect on production.

Smoking, alcohol and substance use. Smoking and heavy alcohol consumption are factors whose relationship with semen values has been examined in a large number of studies.

Weight and inactivity. Excess weight can affect hormonal balance. Regular physical activity is beneficial for general health; activities that put prolonged pressure on the area, such as excessive long-distance cycling, are assessed separately.

Anabolic steroids and testosterone taken from outside. Use that is not under medical supervision may suppress sperm production; how long the effect takes to reverse after stopping varies from person to person.

Medical conditions. Varicocele, that is dilatation of the veins, previous testicular surgery, a history of undescended testis, mumps contracted after puberty, infections involving the reproductive tract, diabetes and thyroid disorders belong under this heading. Certain drug treatments as well as chemotherapy and radiotherapy may also affect production.

Environmental factors. Intensive contact with pesticides, heavy metals, certain solvents and industrial chemicals is a subject of research.

Sleep, stress and recent illness. Irregular sleep and prolonged intense stress are topics studied for their relationship with hormonal balance. Temporary falls in semen values have been reported after an infection with a high fever, and these changes have generally been observed to return towards their earlier level within a few months. If you have recently had a feverish illness, mentioning it to the laboratory and to your doctor when you give the sample helps the result to be interpreted correctly.

Age. Production continues into later life in men, but gradual changes in volume, motility and the integrity of genetic material have been reported with advancing age.

Points to consider in daily life

Habits that support general health apply to reproductive health as well: stopping smoking, limiting alcohol, eating a balanced diet, keeping a regular sleep pattern, managing weight and being physically active. Avoiding prolonged heat exposure and keeping chronic conditions under medical follow-up belong in the same frame.

If you take medicines regularly, you can ask your doctor how they relate to reproductive health; do not stop any medicine on your own decision. Before using any product it is sensible to consult your doctor or your pharmacist.

It is worth being cautious about methods circulating online that promise certain results. Because the production cycle is long, several months usually need to pass before changes in daily habits are reflected in test results.

When to see a doctor

Seeing a urologist is appropriate in the following situations:

• No pregnancy within one year despite regular intercourse without contraception; if the partner is over 35, this period is taken as six months.
• Pain, swelling, firmness or a lump felt in the testicle.
• A sensation of dilated veins resembling a bag of worms in the groin or around the testicle.
• Pain on ejaculation, a marked change in the amount of semen, or blood seen in semen.
• Complaints about sexual function, or signs of hormonal change such as reduced body hair.
• A history of testicular surgery, undescended testis, mumps after puberty, chemotherapy or radiotherapy.
• Additional complaints such as burning on urination and frequent urination; our article on dysuria provides a general frame for this. For urinary complaints that appear with age you can also read our article on benign prostatic hyperplasia.

Reproductive health is a subject shared by a couple; assessment most often covers both partners together. This page is intended as general information; for diagnosis and treatment consult your physician, and for questions about medicines consult your pharmacist.

Frequently asked questions

How many days of abstinence are needed before a semen analysis?

A period of 2 to 7 days of sexual abstinence is generally requested. A very short period may affect the cell count and a very long one the motility values. Following the laboratory's instructions and keeping the same condition for a repeat test makes the results comparable.

Is a single semen analysis conclusive?

No. Semen values can vary markedly from sample to sample in the same person; a feverish illness, fatigue or the length of abstinence may affect the result. Doctors therefore usually request a second examination a few weeks later and interpret it together with history and examination.

Do hot showers, saunas and laptops affect sperm health?

The testicles work slightly below body temperature, which is why prolonged and repeated heat exposure is a subject of study. What is discussed is regular, long-lasting exposure rather than brief everyday contact. It is sensible to discuss your own situation with your doctor.

What does a result below the reference values mean?

Reference values are not a pass or fail threshold but lower limits derived from measurements in a large group. Falling below them is not in itself a definitive conclusion; the assessment is made by a doctor together with history, examination and, where needed, further tests.

Does age affect male reproductive health?

Production continues into later life. Even so, gradual changes in volume, motility and the integrity of genetic material have been reported with advancing age. What these changes mean for an individual is understood through medical assessment.

Do anabolic steroids affect sperm production?

Use of anabolic steroids or testosterone from outside without medical supervision may suppress sperm production. If this applies to you, telling your doctor is important so that the assessment can be made correctly.

Aymed İlaç Sanayi manufactures authorised medicinal products in urology and nephrology. This page does not contain diagnostic or treatment advice; it is intended as general health information.