A sperm analysis (SA), often called a semen analysis, is the foundational diagnostic procedure used to assess male reproductive capacity. This test provides objective measurements of sperm health and quantity by offering a detailed microscopic view of the ejaculate. It is a fundamental step in evaluating couples experiencing difficulty conceiving, providing data that helps determine if male factors are contributing to infertility and guides subsequent treatment strategies.
What a Sperm Analysis Evaluates
The analysis examines several distinct characteristics of the semen sample, providing a comprehensive profile of the sperm population. The primary parameter is sperm concentration, measuring the number of sperm per milliliter of semen. A result below 15 million spermatozoa per milliliter is considered lower than the World Health Organization (WHO) reference value and may indicate oligospermia.
Motility assesses the sperm’s ability to move efficiently and directionally. Specifically, physicians look for progressive motility, where sperm actively swim forward, requiring a minimum of 32% of sperm to show this movement. Morphology determines the percentage of sperm with a correctly formed head, midpiece, and tail. The standard threshold for normal morphology is strict, requiring 4% or more of the observed sperm to have the correct shape needed to penetrate an egg.
The analysis also measures overall semen volume and its pH level. A volume below 1.5 milliliters may suggest a partial blockage or a problem with accessory glands. The analysis checks for non-sperm cells, such as white blood cells, which may indicate an infection or inflammation. These measurements allow physicians to categorize potential issues like poor movement (asthenozoospermia) or abnormal shape (teratozoospermia).
The Role of the Urologist and Andrologist
The interpretation and management of an abnormal sperm analysis primarily fall to a Urologist or an Andrologist. A Urologist is a physician specializing in the urinary tract and the male reproductive system. If a urologist focuses specifically on male reproductive health, often after additional fellowship training, they are referred to as an Andrologist.
The Andrologist is the most specialized physician for diagnosing and treating the physiological causes of male infertility. They order further diagnostic tests, such as hormone panels or a scrotal ultrasound, to look for structural issues. They investigate causes like varicocele (enlarged scrotal veins that impair sperm production) or blockages preventing sperm from reaching the ejaculate.
Treatment may involve prescribing medications to correct hormonal imbalances or performing surgical interventions. An Andrologist can surgically repair a varicocele or perform microsurgical procedures to reconstruct blocked ducts. In cases of severe male factor infertility, they perform sperm retrieval procedures, such as testicular sperm extraction (TESE), to collect sperm directly from the testis for use in assisted reproductive technology.
The Role of the Reproductive Endocrinologist
The Reproductive Endocrinologist (RE) commonly orders and interprets a sperm analysis, often working with an Andrologist. An RE is an obstetrics and gynecology subspecialist focusing on the hormonal aspects of fertility for both partners. They manage the overall fertility treatment pathway for the couple.
While the Andrologist focuses on improving the male partner’s natural function, the RE interprets the SA results alongside the female partner’s health and the couple’s goals. They use the SA data to determine the most appropriate type of assisted reproductive technology (ART). For instance, if the count is low but sufficient, they may recommend intrauterine insemination (IUI).
If sperm parameters are severely low, the RE coordinates care involving in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). They manage the female partner’s ovarian stimulation and oversee the laboratory procedures where the egg and sperm are combined. The RE integrates the male factor diagnosis into a comprehensive, couple-focused treatment plan designed to achieve pregnancy.
The Testing Facility: Technical Staff vs. Physician
While the physician orders and interprets the sperm analysis, the actual microscopic evaluation is performed by specialized technical staff. The test is carried out in an accredited andrology laboratory, often affiliated with a fertility clinic or hospital. The staff performing the complex measurements are highly trained laboratory technicians or embryologists.
These professionals follow strict protocols to ensure accurate assessment of the sample’s parameters. They use specialized counting chambers to determine concentration, examine the sample under a microscope to grade motility, and use staining techniques to evaluate morphology. The resulting detailed report is sent to the ordering physician. The physician translates the technical report into a clinical diagnosis and a treatment recommendation for the patient.