Abnormal Semen Analysis

Abnormal Semen Analysis Results

Male infertility accounts for almost half of infertility and is usually related to abnormal sperm production or function. An abnormal semen analysis is common and even healthy, fertile men can have some irregular sperm.
When an abnormal semen analysis is found to be the cause of infertility, the fertility specialists at Dallas Fort Worth Fertility Associates will want to review the semen analysis finding to determine exactly where the problem lies.


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In a standard semen analysis two things are analyzed, both semen and sperm. The lab evaluates the volume and consistency of semen, the number of sperm present in a given volume (concentration or “sperm count”), the percentage of sperm swimming as well as the quality of motion (motility and grade) and, finally, the shape of the sperm (“morphology”).

Semen analysis covers:

Semen volume – Normal semen volume is described as roughly 1 to 5 milliliters (mL) per ejaculation. In cases of low semen volume, there is not enough fluid to transport sperm into the female reproductive tract, causing fertility problems. When a low semen volume is found, male infertility patients are evaluated for:

Retrograde ejaculation– through a urine test doctors can tell if part or all of the semen flows backwards into the bladder. This condition can be a side-effect of bladder neck surgery, diabetes mellitus or alpha-adrenergic drugs.
Blockages in a seminal vesicle or ejaculatory duct, sometimes due to a varicocele (varicose vein), or cyst
Hormonal abnormalities– testing may be needed to check for low levels of serum testosterone.
Mental Stress– if a sample is given when the patient is under unusual stress, semen volume may be low and the study may need to be repeated.

Viscosity– This term refers to the consistency or thickness of the seminal fluid. Low or moderate viscosity is considered normal and flows easily. If the consistency is too thick, the semen has a harder time leaving the reproductive track. Causes and symptoms associated with semen viscosity include:

Leukocytes – Semen with a high concentration of these are white blood cells, more than 1 million leukocytes per millilitre, can be a sign of inflammation or infection. A small number of leukocytes can be normal, and are seen even in the absence of infection.
Semen color– can be affected by age, diet and frequency of ejaculation. Normal semen is a white, cloudy fluid and quite thick. A change in the color of semen is usually temporary and not a health concern. However, semen with a yellowish-green tent may indicate a prostate infection and you should see your primary care doctor for evaluation.

Sperm analysis covers:

Sperm concentration or sperm count – This is the total number of sperm found in a single ejaculate. Low sperm count is diagnosed when the number of sperm falls below 20 million in a milliliter of semen. (Normal range is between 20 million and 120 million per milliliter of semen.) Low sperm count can be caused by a multitude of factors or not explained at all. Some of the most common causes are:

• Overheating of the testicles
• Stress (emotional, psychological, and physical)
• Drug use
• Smoking
• Nutritional deficiencies and obesity
• Environmental toxins

Sperm motility is a sperm’s capacity for swimming forward and penetrating the egg. Sperm is evaluated on both how fast it moves and if it travels in a straight line. At least 50 percent of sperm should be motile and moving forward, and there are usually 15 million motile sperm in a single sample. The sperms motility can tell how successful the sperm may be at invading the cervical mucus and reaching the egg. Sperm motility in a male can be affected by heat, diet, infections, smoking and prolonged sexual activity.
Sperm Morphology evaluates the shape and size of the sperm. The World Health Organization says good quality semen should contain 30 percent normal sperm morphology. The shape of a sperm can affect its mobility, and therefore ability, to penetrate the ovum. Every man produces abnormal sperm for unknown reasons. Some of the common sperm morphologies are:

• A very large round head
• An extremely small pinpoint head
• A tapered head
• A crooked head
• Two heads
• A tail with kinks and curls

An abnormality in sperm production or function is a common cause of male infertility. If you have been trying for more than a year to get pregnant with no success, or have already had an abnormal semen analysis, there are various treatment options for you. Please contact Dallas Fort Worth Fertility Associates for a full evaluation or semen analysis to get you on the right path to parenthood.