How to test sperm count and quality, and how to prepare for it to conceive a child?

Infertility problems may not always come from the female side, but it has been found that the male partner is also responsible for about 25% of infertility cases. To determine whether the issue is from the male partner, a sperm analysis can be performed. So, how is sperm testing done, and what preparations are needed?

Semen Analysis
A semen analysis is the examination of sperm by a specialized andrologist or fertility scientist to evaluate the male partner’s ability to conceive. This test helps assess male fertility or identify possible reproductive issues.

Before we dive into understanding a sperm analysis or semen test, we first need to understand what sperm actually is.

Semen is the fluid that is ejaculated when a man reaches orgasm. It contains the most essential element for male reproduction — sperm. In addition to sperm, semen also includes lubricating fluids, nutrients for the sperm, and water. It typically appears milky white in color.

However, simply observing semen with the naked eye cannot reveal how many sperm are present or whether the man has normal fertility. To assess this, a sperm analysis or semen test must be performed.

Semen analysis is commonly recommended for men who suspect they may have fertility issues or for those who want to assess their sperm quality. The benefits of semen analysis include:

• Provides a complete assessment of sperm quality, which cannot be determined by the naked eye.

• Reveals the man's reproductive potential, indicating whether he is ready for fatherhood.

• Enables effective family planning based on the sperm quality results.

• Allows for early detection and treatment of underlying health conditions if any abnormalities are found.

When you suspect issues with sperm health and want to check for abnormalities in sperm or the reproductive system — such as trying to conceive for over a year without success — it is advisable to begin testing with the male partner.

This is because semen analysis requires minimal preparation, is non-invasive, and does not involve blood draws or painful procedures.

Semen analysis can also be used for men who have undergone a vasectomy and wish to confirm whether the procedure was successful. This test can help assess whether any sperm remains in the semen.

Semen analysis is an examination to assess the quantity, count, motility, and morphological abnormalities of sperm. There are two main methods:

1. Macroscopic Examination (visual inspection) to observe the general characteristics of the semen:

• Overall color abnormalities of the ejaculated semen

• Clarity or turbidity of the semen

• Liquefaction time (semen should liquefy within 1 hour)

• Semen volume (normally, the volume per ejaculation should be at least 1.5 milliliters)

• Viscosity and pH of the semen

2. Microscopic Examination (using a microscope) to assess:

• Sperm count and motility rate (at least 40% of sperm should be motile)

• Sperm viability (normally, 58% or more of sperm should be alive)

• Percentage of sperm with normal morphology (at least 4% normal forms)

• White blood cells (WBCs) in semen should not exceed 1 million cells per milliliter; higher levels may indicate infection

• Red blood cells (RBCs) should be fewer than 1 million cells per milliliter; higher levels may suggest infection

Semen analysis or sperm testing is not done by visual inspection alone but involves the use of microscopes and various staining technologies. These tests must be performed by specialized laboratory scientists. The advanced technologies enable more detailed and accurate assessments, such as sperm count, viability, motility patterns, and detection of contamination by red and white blood cells.

• • Abstain from sexual intercourse or ejaculation for at least 5–7 days before the appointment.

  • Get enough rest before the test.

  • Wash your hands and genital area thoroughly before collecting the semen sample.

  • Do not use lubricants or condoms during semen collection.

• • Semen volume must be greater than or equal to 1.5 milliliters (> 1.5 ml).

  • Sperm concentration must be greater than or equal to 15 million sperm per milliliter (> 15 M/ml).

  • Sperm motility must be greater than or equal to 40% (> 40%).

  • Sperm morphology (percentage of normal-shaped sperm) must be greater than or equal to 4% (> 4%).

  • Sperm viability (percentage of live sperm) must be greater than 58%.

  • White blood cell count (WBC) in semen should not exceed 1 million cells per milliliter.

  • Red blood cell count (RBC) should be less than 1 million cells per milliliter.

Semen quality testing requires careful sample collection because even a small mistake can affect the test results. For example, before the test, abstain from ejaculation for 5–7 days—not more and not less. During sample collection, the semen must be collected by masturbation only; sexual intercourse or the use of condoms is prohibited. The sample should be collected only in the container provided by the healthcare facility.

Limitations in semen collection

When discussing limitations in semen collection, it includes men who are unable to produce a semen sample, such as those with disabilities or who lack the ability to achieve sexual arousal, resulting in no semen sample available for quality analysis.

Another limitation concerns the collection location. The semen must be collected at the healthcare facility only; it cannot be collected at home or elsewhere and then brought in. This is because transporting the sample from outside locations may damage or kill the sperm. Therefore, men need to prepare and come to the clinic or hospital for sample collection.

How much does a semen analysis cost?

At Beyond IVF, the price for a semen quality test is 1,500 THB. This covers the examination of semen volume, sperm concentration, sperm motility, sperm morphology, sperm viability, white blood cell count, and red blood cell count in the semen.

The results are available within 1–2 hours and are communicated by a specialist scientist for every case.

If you ask, "Where is the best place to get a semen analysis?" choosing the right facility and specialist to perform the test is very important. At Beyond IVF, not only do we have expert laboratory scientists who conduct semen quality analysis, but we also have specialist doctors who provide detailed consultations and thorough interpretation of the results. They can recommend appropriate solutions if any abnormalities are found.

The semen collection rooms are sterilized for each individual case, ensuring cleanliness and safety from infections. Additionally, our team of scientists and nurses are highly experienced and well-trained.

How long does it take to get semen analysis results?
After the male patient provides a semen sample, the results are available within 2 hours. At Beyond IVF, the results are communicated to patients in the evening by specialized laboratory scientists.

How many days should be between semen tests?
Doctors recommend waiting 1 week between semen tests and abstaining from ejaculation before the next test.

Since infertility issues may not always originate from the female partner, but can also come from the male partner, semen quality testing helps identify the true cause of infertility. If abnormalities are found, such as infections or contamination of blood in the semen—which could be the cause of serious diseases—urgent treatment is necessary.

For couples undergoing semen analysis, it is recommended to consult with a doctor together to plan and find individualized treatment options.

If you have any questions or would like to schedule a consultation regarding infertility treatment, please contact us via Line: @beyondivf.