What is a semen analysis?

By Dave S. · · 2 min read · Updated
A microscope on a laboratory bench.
Photo: Unsplash

A semen analysis measures the volume of a semen sample and the number, movement and shape of the sperm in it. It is the main lab test for male fertility, and it is not a blood test: the sample is collected at a clinic or lab, or at home and delivered within 30 to 60 minutes. Blood-test ordering services don’t sell it, but they do sell the hormone tests often ordered alongside it.

What does a semen analysis report?

MeasurementWhat it describes
VolumeHow much fluid is in the sample
Sperm concentrationNumber of sperm per milliliter
Total sperm countSperm in the whole sample
MotilityShare of sperm that are moving
MorphologyShare of sperm with a typical shape
pHHow acidic or alkaline the fluid is

Each laboratory compares these against its own reference values, which differ between labs.

How is a semen sample collected?

  1. Abstain beforehand. MedlinePlus describes avoiding ejaculation for 2 to 7 days before collection. The lab doing the test sets its own window, and its instructions come first.
  2. Collect into the container provided. Usually at the clinic or lab. Some labs allow collection at home, with a kit or a special condom supplied for the purpose.
  3. Keep a home sample warm and move quickly. It has to stay at body temperature and reach the lab within 30 to 60 minutes.
  4. Expect that one sample may not be the last. Sperm counts vary from one sample to the next, so a single result is often confirmed with another.

Why can't you order a semen analysis like a blood test?

Because the whole test depends on a fresh sample reaching a lab set up to examine it within the hour. Patient service centers draw blood into tubes that can travel to a regional laboratory over a day; a semen sample can't wait that long. So a semen analysis is ordered through a fertility clinic, urology practice or andrology lab, and it doesn't appear on self-pay blood-test menus.

Which blood tests are often ordered with it?

FSH, LH and total testosterone, and sometimes prolactin and estradiol. They describe the hormones that drive sperm production, which helps explain a semen result but can't stand in for one. How these markers behave on testosterone therapy is covered in infertility on TRT.

Follicle-Stimulating Hormone (FSH): $4.54 to $89.00 across 17 ordering servicesFollicle-Stimulating Hormone …$4.54Luteinizing Hormone (LH): $4.54 to $139.00 across 17 ordering servicesLuteinizing Hormone (LH)$4.54Testosterone, Total: $6.05 to $129.00 across 18 ordering servicesTestosterone, Total$6.05Prolactin: $8.57 to $79.00 across 17 ordering servicesProlactin$8.57Estradiol, Ultrasensitive (LC/MS-MS): $24.00 to $209.00 across 17 ordering servicesEstradiol, Ultrasensitive (LC…$24.00$0$50$100$150$200$250Cheapest availableUp to the highest listing
Self-pay price range per test, from our own price checks.
TestCheapestHighestServices
Follicle-Stimulating Hormone (FSH)$4.54$89.0017
Luteinizing Hormone (LH)$4.54$139.0017
Testosterone, Total$6.05$129.0018
Prolactin$8.57$79.0017
Estradiol, Ultrasensitive (LC/MS-MS)$24.00$209.0017

Sources

Common questions

Can you buy a semen analysis from a blood-test ordering service?

Usually not. A semen analysis needs a fresh sample examined quickly, so it is ordered through a fertility clinic, urology practice or andrology lab rather than drawn at a patient service center.

Is a semen analysis the same as a testosterone test?

No. A semen analysis examines the sperm and fluid in a semen sample, while a testosterone test measures a hormone in the blood. They answer different questions and are collected in completely different ways.

Does a normal hormone panel make a semen analysis unnecessary?

No. Blood hormone tests describe the signals behind sperm production, not the sperm themselves, so one cannot substitute for the other.

Why might a semen analysis be repeated?

Sperm counts vary from one sample to the next, so a single result is often confirmed with a second sample.

Live self-pay prices, updated by our own price checks.

Follicle-Stimulating Hormone (FSH)
from $4.54 · 17 services
Luteinizing Hormone (LH)
from $4.54 · 17 services
Testosterone, Total
from $6.05 · 18 services
Testosterone, Free (Calculation)
from $13.63 · 17 services
Prolactin
from $8.57 · 17 services
Estradiol, Ultrasensitive (LC/MS-MS)
from $24.00 · 17 services
Sex Hormone-Binding Globulin (SHBG)
from $8.00 · 16 services

More guides

Infertility on TRT: What to Monitor
Testosterone replacement therapy (TRT) often lowers sperm production, because testosterone from outside the body tells the pituitary gland to cut back on LH and FSH, the two signals the testicles need to make sperm. The measurements used to follow this are a semen analysis, which is the direct measure, plus blood levels of LH, FSH, testosterone, estradiol and prolactin.
What blood tests do bodybuilders track?
The blood tests most often discussed in bodybuilding and strength communities fall into four groups: hormones (total and free testosterone, estradiol, SHBG, LH and FSH), general health panels (CBC and CMP), heart and metabolic markers (lipid panel, ApoB, A1c, fasting insulin), and thyroid, iron and vitamin markers. Hard training changes some of these numbers by itself, which matters when comparing results over time.
What Do TSH, T3, and T4 Mean on a Thyroid Panel?
A thyroid panel usually reports three things: TSH, a signal from your pituitary gland, and T4 and T3, the two hormones the thyroid actually makes. TSH tells the thyroid how hard to work, so it often shifts before the hormone levels do. Read together, the three numbers show whether the gland and its control signal are in step.

This article is general information about how lab testing works, not medical advice, and it cannot tell you which tests you need or what your results mean. Talk to a clinician about your own health.