This guide explains what a semen analysis checks, how to prepare for your sample, how results are interpreted, what it costs in Australia and what happens next.
Why male fertility testing matters
About 15% of couples have difficulty conceiving. In about half of these couples a male factor is involved, either on its own or alongside a female factor.
Most men with a sperm problem have no symptoms. Sex drive and function are usually normal, so a semen analysis is the only way to know. It's a simple test and is usually one of the first recommended when a couple is investigating fertility.
What is a semen analysis?
A semen analysis is a laboratory test of a semen sample. It's the main test used to assess male fertility. It looks at how much sperm is present, how well the sperm move and whether they are a normal shape.
At Life Fertility Sydney, semen analysis is part of male fertility testing. Your specialist will give you a referral, and for a basic semen analysis any pathology provider is fine. It's best to choose a collection centre near your home, so you can produce the sample in the comfort of home and get it to the lab quickly.
What does a semen analysis check?
Volume: how much semen is produced
Sperm concentration: how many sperm are in each millilitre
Total sperm number: how many sperm are in the whole sample
Motility: the percentage of sperm that move, and how many move forward
Morphology: the percentage of sperm that are a normal shape
Vitality: the percentage of sperm that are alive
Other markers: pH, white blood cells, which can indicate infection, and sperm antibodies
What is a normal result?
Most Australian laboratories compare results with the World Health Organization's reference values. These are the lower limits of the normal range:
| Measure | Lower reference limit |
|---|---|
| Volume | 1.4 mL |
| Concentration | 16 million per mL |
| Total sperm number | 39 million per sample |
| Total motility | 42% |
| Progressive motility | 30% |
| Vitality | 54% |
| Normal forms (morphology) | 4% |
These values were set using men who had conceived, so they mark the low end of normal rather than a pass or fail. A result below one of them does not mean you are infertile, and a result above them is not a guarantee of fertility.
How to prepare for a semen analysis
Avoid ejaculation for at least 2 days, but no longer than 7 days, before the test.
Collect the sample by masturbation into the sterile container the lab provides.
Don't use lubricant or an ordinary condom. Many lubricants are toxic to sperm. The lab can supply a special collection condom if needed.
Collect the whole sample. The first part contains the most sperm.
Deliver it to the lab within an hour if you collect at home, keeping it warm, close to body temperature. A warm sample reduces the risk of an inaccurate result. Don't refrigerate it or leave it in the sun.
Tell your doctor about recent illness or fever, and any medications you take. A fever can lower sperm numbers for up to three months.
How to interpret your results
Semen quality varies from one sample to the next, so a single result is a snapshot. If a result is outside the normal range, your specialist will usually recommend a repeat test at least six weeks later.
Results are often described using these terms:
Oligozoospermia: a low sperm count
Asthenozoospermia: reduced sperm movement
Teratozoospermia: a lower percentage of normally shaped sperm
Azoospermia: no sperm in the sample
An abnormal result is a starting point for further assessment, not a diagnosis on its own.
What happens if your results are abnormal?
Your specialist may recommend further tests, such as hormone blood tests, genetic tests, an ultrasound or sperm DNA testing. These can help identify the cause and shape treatment planning.
Depending on the results, options may include lifestyle changes, intrauterine insemination, or IVF with ICSI, where a single sperm is injected directly into an egg. Where there is a blockage in the tubes that carry sperm from the testicles, or no sperm is ejaculated because of a production problem in the testes, sperm can be retrieved surgically. This is offered through our services at Vida Fertility Clinic and performed by one of our specialists. Where sperm can't be retrieved, donor sperm is also an option.
Can lifestyle affect your results?
Yes. Factors linked with lower sperm quality include:
smoking
regular or heavy alcohol use
prolonged heat, such as hot baths and saunas
higher body weight
testosterone or anabolic steroids, which can stop sperm production
some medications and recreational drugs
Sperm take about two and a half to three months to develop, so changes you make today show up in a sample around three months later.
How much does a semen analysis cost in Australia?
Semen analysis attracts a Medicare rebate when you have a referral from a GP or specialist. The out-of-pocket cost depends on the pathology lab. Our team can confirm current costs when you book.
If you live in NSW, the one-off $250 Pre-IVF Fertility Testing Rebate covers semen analysis along with other fertility tests. The claim is lodged by the woman having fertility treatment, and the doctor completes the declaration.
What happens after your results
Results are sent to your fertility specialist, usually within a week. Your specialist will review them alongside your history and any other test results, and arrange a follow-up consultation to talk through what they mean and your options.
You'll need a GP referral to see one of our fertility specialists in Potts Point or Kogarah. If you'd like to arrange testing or have your results explained, book a consultation. Not ready for that yet? You can also book a free nurse consultation to talk it through first.
Frequently asked questions
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Home kits give a rough indication of sperm count only. They don't measure movement, shape or the other markers in a laboratory semen analysis, so they can't replace one.
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Yes. You need a referral from a GP or specialist, which also allows you to claim the Medicare rebate.
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Yes, and it's often the best option. Choose a collection centre near your home so you can get the sample to the lab within an hour, keeping it warm on the way.
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Not necessarily. A semen analysis can identify problems with sperm, but it can't measure every factor involved in conception. Your specialist will consider it alongside your history and, if you have a partner, their results.
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If you have a female partner, testing for both of you at the same time gives the clearest picture. Read more about fertility testing for women and the AMH test.
References
World Health Organization (2021). WHO laboratory manual for the examination and processing of human semen, 6th edition. Lower reference limits summary.
Healthy Male. What happens during a semen analysis.
Healthy Male. What is a normal sperm count?
Healthy Male. Male infertility clinical summary guide.
Healthy Male. Infertility.
Medicare Benefits Schedule. Item 73523: semen examination.
Service NSW. Pre-IVF fertility testing rebate.
