Semen analysis diagnoses, explained

If your semen analysis came back with a word you have never seen before, this is the place to start. Each diagnosis below explains what the term means, what the number actually predicts about fertility, and what a reasonable next step looks like.

• Azoospermia

  No sperm in the semen

  No measurable sperm in the ejaculate. Found in about 1% of all men and 10–15% of men with infertility.

  0 million/mL

• Oligospermia

  Low sperm count

  Fewer sperm than the WHO reference threshold. The most common abnormal finding on a semen analysis.

  < 16 million/mL

• Asthenozoospermia

  Poor sperm movement

  Sperm are present in normal numbers but too few move forward effectively to reach the egg.

  < 30% progressive

• Teratozoospermia

  Abnormally shaped sperm

  Fewer than 4% of sperm have a normal shape. The least predictive of the three main parameters.

  < 4% normal forms

• OAT Syndrome

  Low count, motility and morphology together

  Oligoasthenoteratozoospermia — all three main parameters below reference range at once.

  All three below range

• Cryptozoospermia

  Almost no sperm — found only after spinning the sample

  So few sperm that none appear on the initial slide; they are found only after the lab centrifuges the sample.

  < 0.1 million/mL

• Necrozoospermia

  Most sperm are dead, not just still

  A high proportion of sperm are non-viable. Distinguished from poor motility by a vitality stain.

  < 54% vital

• Globozoospermia

  Round-headed sperm with no acrosome

  A rare genetic condition in which sperm lack the acrosome cap needed to penetrate an egg.

  100% round-headed

• Hypospermia

  Low semen volume

  Less than 1.4 mL of semen per ejaculation. Often a collection issue rather than a medical one.

  < 1.4 mL

• Hyperspermia

  Unusually high semen volume

  More than about 6 mL per ejaculation. Rarely a problem in itself, but it can dilute concentration.

  > 6 mL

• Aspermia

  No semen produced at all

  Orgasm occurs but no ejaculate is released. Different from azoospermia, where fluid is produced but contains no sperm.

  No ejaculate

• Leukocytospermia

  Too many white blood cells in the semen

  More than 1 million white blood cells per mL, often signalling infection or inflammation.

  > 1 million WBC/mL

• Hematospermia

  Blood in the semen

  Visible or microscopic blood in the ejaculate. Alarming to see, but usually benign and self-limiting.

  Blood present

• Normozoospermia

  A normal semen analysis

  Every parameter at or above the WHO reference limits — the result you want, and not always the end of the story.

  All parameters normal