Semen Analysis

The semen analysis is the cornerstone of male fertility evaluation. The sample, produced by masturbation after 2–5 days of abstinence, is analyzed for volume, pH, sperm concentration, total motile count, progressive motility, and morphology (Kruger strict criteria). Two separate samples 4–12 weeks apart are recommended to account for natural variation.

WHO 2021 reference ranges include: volume ≥1.4 mL, concentration ≥16 million/mL, total motility ≥42%, progressive motility ≥30%, and normal morphology ≥4%. Results below these thresholds indicate oligospermia (low count), asthenospermia (low motility), or teratospermia (abnormal morphology). Severe abnormalities prompt hormone testing, genetic workup, and urological evaluation.