{"id":6036,"date":"2023-02-05T18:26:27","date_gmt":"2023-02-05T11:26:27","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=6036"},"modified":"2026-08-26T23:00:30","modified_gmt":"2026-08-26T16:00:30","slug":"%e1%9e%80%e1%9e%b6%e1%9e%9a%e1%9e%92%e1%9f%92%e1%9e%9c%e1%9e%be%e1%9e%8f%e1%9f%81%e1%9e%9f%e1%9f%92%e1%9e%8f%e1%9e%98%e1%9f%81%e1%9e%87%e1%9e%b8%e1%9e%9c%e1%9e%b7%e1%9e%8f%e1%9e%88%e1%9f%92%e1%9e%98","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/km\/2023\/02\/05\/sperm-test-semen-analysis\/","title":{"rendered":"Understanding a Semen Analysis: What the Numbers Mean, and What They Do Not"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow 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in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Best Urologist working in Chonburi and Cambodia\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, 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12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 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Around one couple in seven is affected, and a male factor contributes in roughly half of them \u2014 which is why the semen analysis is usually the first test done, and why it is so often misread.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">The most important thing to understand before you read your result<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">An earlier version of this article called the WHO figures a <em>normal reference<\/em> and described results below them as <em>abnormal<\/em>. That framing is the commonest source of unnecessary distress in an andrology clinic, and it has been corrected here.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The WHO figures are not a pass mark.<\/strong> They were produced by measuring the semen of men whose partners conceived within twelve months, and taking the <strong>fifth centile<\/strong> of that group \u2014 the value below which the least fertile one in twenty of those <em>fertile<\/em> men fell. They are a description of a population, not a boundary between fertile and infertile.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two consequences follow, and both matter:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Men whose numbers fall below these limits father children<\/strong> \u2014 one in twenty of the men used to build the reference did exactly that. A result under the line means fertility is statistically reduced, not that conception is impossible.<\/li>\n\n\n\n<li><strong>Men whose numbers are entirely above the limits are sometimes infertile.<\/strong> A semen analysis counts sperm and watches them move; it does not test whether they can fertilise an egg.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The result is a piece of information about a couple&#8217;s chances, to be read alongside the female partner&#8217;s assessment. It is not a verdict on a man.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"534\" data-attachment-id=\"6048\" data-permalink=\"https:\/\/drsoaraweeurology.com\/km\/2023\/02\/05\/sperm-test-semen-analysis\/portrait-of-stressed-young-asian-couple-looking-upset-after-fighting\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?fit=1200%2C801&amp;ssl=1\" data-orig-size=\"1200,801\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Studio shot of young Asian man and young Asian woman together against white background&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Portrait of stressed young Asian couple looking upset after fighting&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Sperm test or semen analysis interpretation\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Infertility issue bring nightmare to the couple whom suffer.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=800%2C534&#038;ssl=1\" alt=\"Couple sitting together looking concerned, illustrating the emotional impact of a fertility investigation\" class=\"wp-image-6048\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=1024%2C684&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=768%2C513&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Unhappy-couple.jpg?resize=750%2C501&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Fertility is a property of a couple. A semen analysis answers only part of the question.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Producing a sample that can actually be interpreted<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">More abnormal results come from collection problems than from disease. Getting this right saves repeat tests and needless worry.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Abstain for two to seven days beforehand.<\/strong> Much longer does not improve the result and worsens motility.<\/li>\n\n\n\n<li><strong>Produce the sample by masturbation<\/strong>, into the sperm-safe container the laboratory provides. If a condom must be used it has to be a special non-toxic collection condom \u2014 <strong>an ordinary latex condom kills sperm<\/strong> and makes the result meaningless.<\/li>\n\n\n\n<li><strong>Tell the laboratory if any of the sample was spilled<\/strong>, particularly the first portion, which carries most of the sperm. An incomplete collection is the commonest reason a volume or count looks falsely low.<\/li>\n\n\n\n<li><strong>Keep it near body temperature and deliver it within an hour.<\/strong> Do not refrigerate it.<\/li>\n\n\n\n<li><strong>Mention a recent fever or illness.<\/strong> A fever six to eight weeks earlier can wreck a result from a man whose sperm production is entirely normal, because of how long the production cycle takes.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"6046\" data-permalink=\"https:\/\/drsoaraweeurology.com\/km\/2023\/02\/05\/sperm-test-semen-analysis\/cropped-photo-of-young-woman-with-white-manicure-raising-hand-while-thumbing-up-showing-positive-emotions-while-posing-against-white-background\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Cropped photo of young woman with white manicure raising hand while thumbing up, showing positive emotions while posing against white background&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Cropped photo of young woman with white manicure raising hand while thumbing up, showing positive emotions while posing against white background&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Sperm test or semen analysis interpretation\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;It is better to know how to prepare good semen specimen for maximizing result accuracy.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Laboratory specimen container used for semen analysis collection\" class=\"wp-image-6046\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Good-specimen.jpg?resize=750%2C500&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Collection technique affects the result more than most men expect.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The reference limits<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK564369\/\">World Health Organization<\/a> issued its fifth edition in 2010 and its sixth in 2021, and <strong>laboratories have not all moved across at the same time<\/strong> \u2014 so your report may quote either set. Both are given below. The differences are small, and none of them turns a normal result into an abnormal one or the reverse; if your figures sit near a line, which edition your laboratory used matters far less than the points made above about what these limits actually represent.<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><tbody><tr><td><strong>What is measured<\/strong><\/td><td><strong>5th ed. (2010)<\/strong><\/td><td><strong>6th ed. (2021)<\/strong><\/td><td><strong>What a low value can indicate<\/strong><\/td><\/tr><tr><td>Semen volume<\/td><td>1.5 mL<\/td><td>1.4 mL<\/td><td>Incomplete collection first of all; then retrograde ejaculation, ejaculatory duct obstruction, or absence of the vas deferens<\/td><\/tr><tr><td>Sperm concentration<\/td><td>15 million\/mL<\/td><td>16 million\/mL<\/td><td>Varicocele, undescended testis in childhood, genetic causes, heat or toxin exposure, and \u2014 less often than assumed \u2014 a hormonal cause<\/td><\/tr><tr><td>Total sperm number<\/td><td>39 million<\/td><td>39 million<\/td><td>More meaningful than concentration alone, since concentration depends on volume<\/td><\/tr><tr><td>Progressive motility<\/td><td>32%<\/td><td>30%<\/td><td>Antisperm antibodies, infection, varicocele, or delay and cooling between production and analysis<\/td><\/tr><tr><td>Total motility<\/td><td>40%<\/td><td>42%<\/td><td>As above<\/td><\/tr><tr><td>Vitality<\/td><td>58%<\/td><td>54%<\/td><td>If motility is poor but most sperm are alive, the problem is with the tail rather than with survival<\/td><\/tr><tr><td>Normal forms<\/td><td>4%<\/td><td>4%<\/td><td>Strict criteria \u2014 4% is the reference limit, not a sign that 96% of sperm are defective<\/td><\/tr><tr><td>White blood cells<\/td><td colspan=\"2\">under 1 million\/mL<\/td><td>Possible genital tract infection or inflammation, which warrants investigation rather than automatic antibiotics<\/td><\/tr><tr><td>pH<\/td><td colspan=\"2\">7.2<\/td><td>Low pH with low volume suggests obstruction or absent seminal vesicles<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Two further corrections to the earlier version. It gave <strong>two different concentration thresholds<\/strong> in the same section, which was simply an error. And it attributed low concentration chiefly to <strong>hormonal causes<\/strong>; hormonal problems are important because they are among the few that are treatable, but they are a minority of cases, and the list above reflects that better.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If no sperm are found at all<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This was missing from the earlier version, and it is the result that matters most.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A report of no sperm \u2014 azoospermia \u2014 should never be accepted on a single test.<\/strong> The laboratory must spin the entire sample and examine the pellet, because small numbers of sperm are often found that way, and the test must be repeated. Only then does the real question arise: whether sperm are being produced but cannot get out, or are not being produced.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Distinguishing the two requires examination, hormone tests including FSH and testosterone, and \u2014 where production is the problem \u2014 <strong>genetic testing, specifically a karyotype and Y chromosome microdeletion analysis<\/strong>. This is not a formality: the results change what treatment can be offered, and they carry information for any children conceived with assisted reproduction. Blockage is often correctable, and even where production is very poor, sperm can sometimes be retrieved surgically.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">An absent count is a reason for proper assessment, not a conclusion.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How many tests, and when to repeat<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Semen quality varies considerably in the same man from week to week, which is why a single poor result proves very little. Two samples, taken some weeks apart, give a far better picture than one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Where something has been found and treated, allow <strong>at least three months<\/strong> before repeating \u2014 sperm take about that long to be made and mature, so a test done sooner is still reporting on the situation before treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See also <a href=\"https:\/\/drsoaraweeurology.com\/2023\/02\/19\/chances-pregnancy-rate\/\">what the monthly chance of conception actually is<\/a>, and \u2014 if testosterone treatment is being considered \u2014 <a href=\"https:\/\/drsoaraweeurology.com\/2023\/03\/22\/hcg-male-hypogonadism\/\">how testosterone therapy affects fertility and what the alternatives are<\/a>. Testosterone given from outside the body suppresses sperm production, and a man who has not finished having children should say so before starting it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Findings that need attention rather than a repeat test<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">See a urologist promptly for any of the following. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A lump in a testis.<\/strong> Testicular cancer is commonest at exactly the age men are investigated for fertility, and it is occasionally found during that investigation.<\/li>\n\n\n\n<li>No sperm on the report \u2014 this needs assessment rather than another test alone.<\/li>\n\n\n\n<li>Blood in the semen, or pain on ejaculation.<\/li>\n\n\n\n<li>Loss of desire, poor erections or reduced shaving frequency alongside a poor count \u2014 this combination points to the hormonal axis.<\/li>\n\n\n\n<li>Sudden severe testicular pain \u2014 that is an emergency the same day, whatever else is going on.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Semen Analysis<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">My result is below the reference limit. Does that mean I cannot have children?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. The reference limits are the fifth centile of men whose partners conceived within a year \u2014 meaning one in twenty of those fertile men fell below them. A result under the line means the chance per cycle is lower, not that pregnancy is impossible, and many men below these figures father children naturally.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My result is normal. Does that rule out a male problem?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Not entirely. The test counts sperm and observes movement; it does not establish that the sperm can fertilise an egg. A normal result makes a male factor less likely and does not exclude it, which is why both partners are assessed.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How should I prepare the sample?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Abstain two to seven days, produce by masturbation into the container the laboratory supplies, avoid ordinary latex condoms entirely, keep the sample near body temperature, deliver it within an hour, and tell the laboratory if any was spilled or if you have had a fever in the past two months.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Only 4% of my sperm are normally formed. Is that as bad as it sounds?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It sounds far worse than it is. Morphology is assessed by strict criteria under which even fertile men have a low percentage of perfectly formed sperm; 4% is the reference limit, not a sign that something has gone badly wrong.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">The report says no sperm were found. What happens next?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It should not be accepted on one test. The laboratory should centrifuge the whole sample and examine the pellet, and the test should be repeated. Assessment then distinguishes blockage from failure of production, using examination, hormone tests and genetic testing including karyotype and Y chromosome microdeletion. Blockage is often correctable, and sperm can sometimes be retrieved surgically even when production is poor.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How many tests do I need?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Two samples weeks apart are much more informative than one, because results vary substantially in the same man. After treatment, wait at least three months before repeating, since sperm take about that long to be produced and mature.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees male fertility and andrology patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring the actual laboratory reports rather than a summary, and any results your partner already has.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/\",\n      \"name\": \"Understanding a Semen Analysis: What the Numbers Mean, and What They Do Not\",\n      \"description\": \"WHO semen reference limits are the fifth centile of men whose partners conceived within twelve months, not a threshold separating fertile from infertile men.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2023-02-05\",\n      \"dateModified\": \"2026-08-26\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/#semen-analysis\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"The earlier version of this article described the WHO figures as normal values and results below them as abnormal; they are fifth centile reference limits derived from men whose partners conceived within twelve months, and that framing has been corrected. Both the fifth edition of 2010 and the sixth edition of 2021 lower reference limits are now tabulated side by side, because laboratories have not all adopted the sixth edition and a patient's report may quote either set. Two conflicting sperm concentration thresholds were given in the same section and have been resolved. Low concentration was attributed chiefly to endocrine causes, which are a minority. Azoospermia was absent from the article entirely and is now covered, including centrifugation of the pellet, repeat testing, and karyotype and Y chromosome microdeletion analysis.\"\n    },\n    {\n      \"@type\": \"MedicalTest\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/#semen-analysis\",\n      \"name\": \"Semen analysis\",\n      \"description\": \"Laboratory assessment of ejaculate measuring volume, pH, sperm concentration, total number, motility, vitality and morphology, together with leucocyte count. Interpreted against WHO lower reference limits, which represent the fifth centile of men whose partners conceived within twelve months rather than a threshold of fertility.\",\n      \"usedToDiagnose\": {\n        \"@type\": \"MedicalCondition\",\n        \"name\": \"Male factor infertility\",\n        \"possibleTreatment\": {\n          \"@type\": \"MedicalTherapy\",\n          \"name\": \"Treatment directed at the identified cause, which may include varicocele repair, correction of obstruction, hormonal therapy where the axis is at fault, surgical sperm retrieval, or assisted reproduction\"\n        }\n      },\n      \"preparation\": \"Two to seven days of abstinence; collection by masturbation into a sperm-safe container; ordinary latex condoms are spermicidal and must not be used; sample kept near body temperature and delivered within one hour; any spillage and any febrile illness in the preceding two months reported to the laboratory.\",\n      \"normalRange\": \"Laboratories may report against either WHO edition. Sixth edition (2021) lower reference limits: volume 1.4 mL, concentration 16 million per mL, total 39 million per ejaculate, progressive motility 30 percent, total motility 42 percent, vitality 54 percent, normal forms 4 percent by strict criteria. Fifth edition (2010): volume 1.5 mL, concentration 15 million per mL, total 39 million, progressive motility 32 percent, total motility 40 percent, vitality 58 percent, normal forms 4 percent. Leucocytes under 1 million per mL and pH 7.2 in both.\",\n      \"signDetected\": \"Azoospermia requires examination of the centrifuged pellet and a repeat test before acceptance, followed by assessment to distinguish obstructive from non-obstructive causes, including FSH and testosterone measurement and genetic testing by karyotype and Y chromosome microdeletion analysis.\"\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/05\/sperm-test-semen-analysis\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My semen analysis is below the reference limit. Does that mean I cannot have children?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. The reference limits are the fifth centile of men whose partners conceived within a year, so one in twenty of those fertile men fell below them. A result under the line means a lower chance per cycle, not that pregnancy is impossible.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My report quotes different reference numbers from another laboratory. Which is right?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Both may be. Laboratories report against either the 2010 fifth edition or the 2021 sixth edition of the WHO manual, and the lower reference limits differ slightly. The differences are small and do not turn a normal result into an abnormal one.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My semen analysis is normal. Does that rule out a male problem?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Not entirely. The test counts sperm and observes movement but does not establish that they can fertilise an egg. A normal result makes a male factor less likely without excluding it.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"The report says no sperm were found. What happens next?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It should not be accepted on one test. The laboratory should centrifuge the whole sample and examine the pellet, and the test repeated. Assessment then distinguishes obstruction from failure of production using examination, hormone tests and genetic testing including karyotype and Y chromosome microdeletion analysis.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>The WHO figures on a semen analysis report are not a pass mark. They are the fifth centile of men whose partners conceived within a year \u2014 which is why men below them father children and men above them sometimes cannot.<\/p>","protected":false},"author":185281453,"featured_media":10094,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"How to read a sperm test properly. 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