Semen analysis – evaluation of male fertility

A semen analysis is a laboratory test in which the quality of semen is assessed by examining a semen sample under a microscope. The test measures sperm count, concentration, and motility as well as semen volume and composition. The purpose is to determine whether the semen contains enough healthy sperm to achieve fertilization and to guide toward appropriate fertility treatment options.

A reduced sperm count (oligospermia) or complete absence of sperm (azoospermia) is a significant cause of male infertility. Sperm motility helps determine how many sperm move actively and forward. The sample is also evaluated for parameters such as semen volume and sperm morphology.
A semen analysis helps identify potential fertility problems and is often the first step in investigating infertility.

room at the clinic or at home, following specific instructions. Before giving the sample, men should abstain from ejaculation for 1–2 days. The sample is nearly always obtained through masturbation directly into a sterile sample container provided by the clinic. In the laboratory, specialists analyze the sample carefully, and the results are reviewed together with a doctor. Results are usually ready within a day.

If producing a sample is difficult or impossible, or if sperm are completely absent from semen, for example due to a previous sterilization, the TESA method can be used to retrieve sperm.

Preparation for the analysis:

• Abstain from ejaculation for 1–2 days before sample collection
• Avoid alcohol and excessive stress in the days before giving the sample

Semen quality can often be improved through natural means. A healthy and balanced diet, regular physical activity, and sufficient sleep support sperm production and motility. Reducing alcohol consumption and quitting smoking or other nicotine products can also significantly improve sperm and semen quality.

Positive changes can often be seen within a few months, as sperm development takes about 3 months. This means that lifestyle changes may be reflected in test results 3–4 months later.

If lifestyle changes are not sufficient, medical treatment options may be needed. A fertility specialist can help assess your situation and suggest appropriate measures to improve your chances of starting a family.

In addition to the basic semen analysis, there are several supplementary tests that help determine the causes of male infertility, define treatment if necessary, or select the appropriate assisted reproduction method.

1. MAR IgG test – a test for anti-sperm antibodies. The MAR IgG test is a recommended additional analysis during the very first semen examination.
2. HaloSperm – this test shows whether there are DNA breaks in sperm cells and to what extent.
3. IL-6 measurement from semen – a marker of local inflammation.
4. HBA – this test shows the proportion of mature sperm cells. The HBA test helps assess semen quality, sperm maturity, and fertilization potential.
5. MiOXSYS – this test allows the determination of oxidative stress levels in sperm and helps evaluate the need for antioxidant supplementation.
6. Eosin test – shows sperm viability, meaning how many sperm cells are capable of fertilizing the egg.
7. Aerobic culture – identifies the presence of aerobic bacteria, which may indicate inflammation.