Why every man should consider a sperm test – The key to understanding male fertility
When couples struggle to conceive, the first thought often turns to female fertility. Yet, nearly half of infertility cases involve male factors, making sperm analysis (spermatogram) an essential, yet often overlooked, diagnostic tool. Just as women rely on hormone testing to understand their reproductive health, sperm testing gives men a clear picture of their fertility and overall reproductive function.
This simple test could be the first step toward solving a complex problem—and even for men who are not yet trying to conceive, it provides valuable insight into their health.
Why sperm testing matters?
Identifying the causes of infertility
Sperm testing is often the first step in uncovering why conception isn’t happening. Poor sperm quality or other abnormalities can play a crucial role in a couple’s fertility challenges, and early testing can save time, money, and emotional stress.
Measuring sperm count
The concentration of sperm—how many sperm cells are present in one milliliter of semen—is one of the most important indicators of male fertility. A low sperm count significantly reduces the chance of successful conception.
Evaluating sperm morphology
Shape matters. Sperm with normal structure are more likely to reach and fertilize an egg. Sperm testing identifies abnormalities in shape that can affect fertility potential.
Assessing sperm motility
Healthy sperm should move forward with speed and purpose. Motility testing shows how many sperm are actively swimming and in the right direction—critical for natural conception.
Checking sperm viability
How long do sperm survive in semen? This information is key for timing intercourse or assisted reproductive procedures like IVF.
Detecting underlying health issues
Sometimes, sperm testing uncovers hidden problems—such as infections, immune-related issues, or genetic conditions—that can affect not only fertility but also overall health.
For a long time, infertility was considered to be solely a female issue, but we now know that in nearly half of all cases, male factors also play a role.
The key role of semen analysis in infertility treatment
Let's find out some details!
Sperm analysis is an extremely important tool in assessing male reproductive health, especially in cases of infertility. This test allows andrologists to obtain information about sperm quality, which is crucial for achieving pregnancy. It is similar to testing reproductive hormones in women; without it, it is impossible to truly determine whether a man is healthy from a reproductive standpoint.
In cases of infertility, sperm analysis plays a key role in diagnosis and treatment planning. Infertility tests are the first tests performed on men, as without them it is impossible to say with certainty whether a given patient is capable of impregnating his partner. If the results show abnormalities, it is important to undergo an andrological examination to identify the causes of the altered sperm profile.
Overall, semen analysis is an essential tool in assessing male reproductive health and plays a key role in identifying and treating the causes of infertility. Timely and professionally interpreted tests can help couples choose the right treatment path to achieve their desired pregnancy and expect a healthy child.
Sperm analysis
Sperm analysis (also known as a spermogram or basic andrological examination) is a simple procedure: the man provides a semen sample through masturbation, which is then analyzed in a laboratory.
Based on WHO standards, the following are evaluated:
-
Volume (at least 1.5 ml)
-
Sperm count (at least 15 million/ml)
-
Motility (at least 40% should be motile, 32% actively motile)
-
Shape (morphology) – proportion of normally shaped sperm
-
pH, viscosity, cellular elements – signs of inflammation or infection
It is recommended to abstain from sexual activity for 3–5 days before providing the sample.
Common abnormalities:
-
Oligozoospermia – low sperm count
-
Asthenozoospermia – poor motility
-
Teratozoospermia – too many abnormally shaped sperm
-
Azoospermia – no detectable sperm in the semen
-
Leukocytospermia – presence of white blood cells indicating inflammation
The result must be repeated because sperm count can change (it can deteriorate due to stress, fever, or medication).
What happens if the results are abnormal?
If a sperm test shows deviations from the norm, an andrologist (male fertility specialist) will typically order additional examinations, such as:
Hormonal tests:
-
FSH, LH: To check how the pituitary gland regulates the testicles.
-
Testosterone: The key hormone for sperm production.
-
Prolactin, SHBG: Less common but sometimes necessary.
Genetic testing
-
Y-chromosome microdeletions
-
CFTR gene mutations (for congenital absence of the vas deferens)
-
Karyotype testing (to rule out conditions like Klinefelter syndrome)
Imaging
-
Testicular ultrasound: To identify varicoceles, blockages, or other abnormalities.
-
MRI: If pituitary dysfunction is suspected.
Treatment opinions
The right treatment depends entirely on the underlying cause:
-
Conservative treatment: Hormone replacement (if hormone levels are low), antioxidant therapy (zinc, selenium, vitamin E, coenzyme Q10), or antibiotics (for infections).
-
Surgical treatment: Varicocele repair (to improve sperm production) or sperm aspiration (TESA/TESE) if sperm are absent from the semen.
-
Assisted reproduction: If natural conception is unlikely, options include intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI)—where even a single healthy sperm can lead to pregnancy.
Steps of sperm analysis
1. Submitting the sample
We ask our patients to submit the sample at home and deliver it to the laboratory within a maximum of 2 hours, at body temperature. This is followed by the sperm analysis procedure.
The assistant will take the sample, labeling it with your name, date of birth, and identification code. Identification is essential, as this test is specific to the individual.
2. Sample verification and documentation
Our biologist will:
check that the sample container is intact,
records the time of the previous ejaculation (which must be at least 3 and no more than 5 days ago),
documents the circumstances of the sample collection (time, place, mode of transport),
and records the macroscopic characteristics: volume, color, pH, viscosity, and coagulation time.
3. Preparation for testing
According to the 6th edition of the WHO guidelines, specific preparatory steps are required for testing:
Incubation of the sample at 37 °C until complete liquefaction (10–60 minutes).
Mixing and homogeneous distribution to ensure accurate evaluation.
An appropriate volume is taken from the sample for various tests.
4. Determination of test parameters (according to WHO standards)
The following main parameters are measured during sample analysis:
5. Quality assurance and validation
Once all measurement data has been recorded:
The biologist checks the internal QC (quality control) values.
If necessary, the test is repeated.
The findings are reviewed a second time and signed by a validating andrologist.
This guarantees that the result is reliable and suitable for medical decision-making.
6. Issuing and interpreting the findings
The final result:
is given to the patient in writing, together with the WHO reference values (e.g., concentration: ≥15 million/ml; morphology: ≥4% normal form, etc.),
This is often accompanied by a medical consultation or andrological counseling, for which patients register with the andrologist after receiving a non-negative result.
If there is a deviation, a repeat or additional test (DNA fragmentation, MAR test, etc.) may be recommended.
