Sperm Count Analysis: What the Semen Report Numbers Mean

You got the semen report back, and it’s a page of numbers with an asterisk next to one of them. A sperm count analysis is easier to read than it looks: 50 million/ml, for example, is comfortably normal, and a single low result is rarely the final word. Here is each line explained, the everyday things that lower the numbers, and when to see a specialist.

Sperm Count Analysis: The Report Line by Line

Labs in Pakistan and India mostly compare results with the World Health Organization’s reference values. These are lower limits drawn from men who fathered a child within a year: being above them is reassuring, being below them means lower chances rather than impossibility, and many men below the line still become fathers.

Older reports may use the previous WHO edition, with slightly different cut-offs such as 15 million/ml and 40% motility. The idea is the same.

Sperm count 50 million/ml: is that good?

Yes. It’s well above the lower limit. Concentration is only one line, though. Check motility and morphology on the same report, and total count, which multiplies concentration by volume.

The words on the report

• Oligozoospermia: low count.
• Asthenozoospermia: low motility.
• Teratozoospermia: few normally shaped sperm. Most men have a low percentage of “perfect” sperm; the 4% line is normal.
• Azoospermia: no sperm seen. Needs a specialist, as there are several causes and some are fixable.
• Pus cells or white cells raised: possible infection or inflammation; the doctor may test further.

Giving a Sample That Gives a True Result

Bad collection is a common cause of a falsely poor report. Easily avoided, too.

1. Abstain from ejaculation for 2 to 7 days before; the lab will give you its window. Longer isn’t better.
2. Collect the whole sample into the sterile pot from the lab. Missing the first part loses most of the sperm.
3. Don’t use ordinary condoms, oil, saliva or lubricant; they can kill sperm.
4. If collecting at home, get it to the lab within about 1 hour, kept close to body temperature (an inner pocket), not in a cold car.
5. Tell the lab if any was spilled, and note any fever in the previous 3 months, since fever can lower counts for weeks.
6. Repeat an abnormal test after a few weeks, ideally at the same lab.

Everyday Things That Lower the Numbers

Testicles work best a few degrees cooler than the rest of the body, which is the whole reason they hang outside it, and anything that keeps them warm for hours every day, whether it’s a job, a habit or simply tight clothes in a Lahore June, can pull the numbers down. Heat is the classic enemy.

• Heat: long hot baths, laptops on the lap, heated car seats, tight underwear, and jobs near furnaces, ovens and tandoors, or driving for many hours daily.
• Smoking, including sheesha and naswar, and heavy alcohol.
• Steroids and testosterone from the gym, even if stopped months ago.
• Weight: carrying a lot of extra weight around the belly affects hormones.
• Illness: a high fever in the last 3 months, uncontrolled diabetes, mumps after puberty.
• Varicocele: swollen veins above the testicle, like a “bag of worms”, more often on the left.
• Some medicines: including certain treatments for ulcers, hair loss and inflammatory conditions; ask your doctor before changing anything.

Because sperm take about three months to form, any change you make needs roughly that long before a repeat test can show it.

When to See a Specialist

Couples are generally advised to see a doctor after 12 months of regular unprotected sex without pregnancy, or after 6 months if the woman is 35 or older. Sooner if there’s a known problem: very low count or azoospermia, previous testicular surgery or injury, a varicocele, or cancer treatment. Both partners should be checked at the same time; infertility is a shared question and a man’s test is simple and cheap compared with many women’s tests. A urologist or andrologist examines, orders hormone tests and ultrasound as needed, and discusses options from varicocele repair to assisted reproduction.

One more thing, because it happens so often. In many families the wife is sent from clinic to clinic for years, through scans, tubes and tablets, while nobody asks the husband to spend fifteen minutes giving a sample, and when a report finally comes back low it is kept secret, or the man is taken to a “gupt rog” clinic that sells him powders instead of examining him. A low count is a medical finding. Nothing more. It says nothing about manhood.

Blood sugar can matter here too; see blood sugar numbers in plain words. For erection problems, which are a separate issue, see when mardana kamzori is a medical warning sign. More on the Desi Remedies hub.

Semen Report Questions