Every number on your semen analysis, explained

A semen analysis report is a table of numbers with a reference range next to each. This guide walks through each parameter: what it measures, the WHO 2021 reference range, what a low or high result actually predicts, and what tends to move it.

Sperm count

  • Sperm concentration

    Concentration (M/mL) or Sperm Density

    The number of sperm in each millilitre of semen, reported in millions per mL; the WHO 2021 lower reference limit is 16 M/mL.

    ≥ 16 M/mL

  • Total sperm count

    Total Sperm Count (M/ejaculate) or Total Sperm Number

    The total number of sperm in the whole ejaculate (volume × concentration); the WHO 2021 lower reference limit is 39 million.

    ≥ 39 M per ejaculate

Sperm movement

  • Total motility

    Motility, Total (%) or Total Motile (PR + NP)

    The percentage of sperm that are moving at all, whether progressively or in place; the WHO 2021 lower reference limit is 42%.

    ≥ 42%

  • Progressive motility

    Progressive Motility (%) or PR / Forward Progression

    The percentage of sperm actively swimming forward rather than moving in place; the WHO 2021 lower reference limit is 30%.

    ≥ 30%

  • Total motile count (TMC)

    Total Motile Count / TMSC (million) — may be absent on basic reports

    The number of moving sperm in the whole ejaculate, derived as volume × concentration × motility; about 20 million or more is the usual functional target.

    ≥ 20 M motile (functional cut-off, not a WHO limit)

Sperm shape

  • Sperm morphology

    Morphology, Normal Forms (%) or Strict (Kruger) Morphology

    The percentage of sperm with a normal shape under strict (Kruger) criteria; the WHO 2021 lower reference limit is 4%.

    ≥ 4% normal forms

Sperm vitality

  • Sperm vitality

    Vitality (%) or Viability / Live Sperm (%)

    The percentage of sperm that are alive, measured with a membrane-integrity stain; the WHO 2021 lower reference limit is 54%.

    ≥ 54% live

Semen volume & chemistry

  • Semen volume

    Volume (mL)

    The amount of fluid in the ejaculate, measured in millilitres; the WHO 2021 lower reference limit is 1.4 mL.

    ≥ 1.4 mL

  • Semen pH

    pH

    How acidic or alkaline the semen is; the WHO 2021 lower reference limit is 7.2, and most normal samples fall between 7.2 and 8.0.

    ≥ 7.2

  • Liquefaction time

    Liquefaction (min) or Liquefaction: Complete / Incomplete

    How long the semen takes to change from a gel to a liquid after ejaculation; WHO 2021 expects complete liquefaction within 60 minutes.

    ≤ 60 min

  • Semen viscosity

    Viscosity: Normal / Increased (or graded 1+ to 4+)

    How thick and stringy the liquefied semen is; it is reported qualitatively, and the expected result is normal (a thread under 2 cm when dripped).

    Normal / not increased

Other cells in the semen

  • Round cells

    Round Cells (M/mL) and/or WBC / Leukocytes (M/mL)

    Non-sperm cells in the semen, mostly white blood cells and immature sperm precursors; WHO 2021 flags more than 1 million peroxidase-positive white cells per mL as leukocytospermia.

    ≤ 1 M/mL (peroxidase-positive WBC < 1 M/mL)

  • Sperm agglutination

    Agglutination: None / Present (graded 1–4, with pattern)

    Motile sperm sticking to each other in clumps, which suggests antisperm antibodies; the expected finding is none, or at most slight.

    None to slight

Sperm DNA

  • DNA fragmentation index (DFI)

    DNA Fragmentation Index (%) / DFI / % DNA Fragmentation

    The percentage of sperm with broken or damaged DNA strands, measured by a separate test rather than a routine semen analysis; under 15% is generally considered excellent and over 30% poor.

    ≤ 15% (lab-dependent: < 15 excellent, 15–25 good, 25–30 fair, > 30 poor)

Male fertility hormones

  • FSH (follicle-stimulating hormone)

    FSH, Serum (mIU/mL)

    The pituitary hormone that tells the testicles to make sperm. High FSH with a low count usually means the testicles themselves are struggling.

    1.5–12.4 mIU/mL

  • LH (luteinizing hormone)

    LH, Serum (mIU/mL)

    The pituitary hormone that tells the Leydig cells to make testosterone. Read together with testosterone, it shows whether low T starts in the testicles or in the brain.

    1.7–8.6 mIU/mL

  • Total testosterone

    Testosterone, Total, Serum (ng/dL)

    The main male sex hormone, made in the testicles. Low levels affect libido, energy and sperm production, but taking testosterone as a treatment shuts sperm production down.

    300–1000 ng/dL

  • Estradiol (E2)

    Estradiol, Serum (pg/mL)

    The main estrogen, present in men at low levels. Too much of it, usually from converting testosterone in body fat, suppresses the pituitary and lowers sperm production.

    10–40 pg/mL

  • Prolactin

    Prolactin, Serum (ng/mL)

    A pituitary hormone that, when elevated, switches off the signals for testosterone and sperm production. Usually caused by medications, stress, or a small benign pituitary growth.

    < 20 ng/mL

  • SHBG (sex hormone-binding globulin)

    Sex Hormone Binding Globulin, Serum (nmol/L)

    The liver protein that carries most of your testosterone. Its level decides how much of a "normal" total testosterone is actually available to your tissues.

    10–57 nmol/L

  • Inhibin B

    Inhibin B, Serum (pg/mL)

    A hormone made by the Sertoli cells that directly reflects sperm production. Low inhibin B with high FSH signals poor spermatogenic reserve.

    > 80 pg/mL

How to read a reference range

The WHO reference limits are the 5th percentile of men whose partners conceived within 12 months. They are not a pass/fail line: a result under the limit places you in the lower end of a fertile population, not outside it. Semen parameters vary a lot from sample to sample, so a single out-of-range result should be confirmed with a repeat test 2–3 months later.

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