The most important analysis when trying to conceive
A semen analysis is the standard test for assessing male fertility. It analyzes the quality of the ejaculate, particularly the concentration, motility, and morphology of the sperm. For men wishing to have children, a semen analysis is often the first step in determining whether there is a reduction in fertility. However, even without a current desire to have children, a semen analysis can provide important information about hormone levels, inflammatory processes, lifestyle factors, or environmental influences .
Especially in men's health, semen analysis is increasingly used preventively today, as part of an extended check-up or to assess endocrine health , particularly when symptoms such as loss of libido, exhaustion or testosterone deficiency occur.
What is examined in a sperm analysis?
The sperm analysis provides information on several key parameters that together reflect a man's fertility :
- Sperm concentration (number per milliliter of ejaculate)
- Total number of sperm (per ejaculate)
- Motility (sperm movement)
- Morphology (shape and structure of sperm)
- Ejaculate volume
- pH value, viscosity, liquefaction time
- Possibly detection of inflammatory cells or antibodies (MAR test)
Depending on the laboratory, oxidative stress , DNA fragmentation or vitality tests may also be performed to better assess the quality and resilience of the sperm.
When is a sperm analysis useful?
A sperm analysis is recommended if:
- A couple has been having unprotected sex for >12 months, but no pregnancy occurs.
- There is a suspicion of impaired testicular function (e.g., after mumps, inguinal hernia, varicose veins in the testicles).
- Before planned fertility treatment (IVF/ICSI)
- To check the success of a vasectomy
- In cases of testosterone deficiency, loss of libido, or hormone therapy
- Preventive measures in cases of past unfulfilled desire to have children or family history of childbearing problems
How is a sperm analysis performed?
Sample collection typically takes place after 2–7 days of sexual abstinence, via masturbation, in a special room at the urology practice or laboratory. The sample must be collected in a sterile container and analyzed as fresh as possible (within 60 minutes) . Alternatively, home collection is possible, provided the laboratory accepts the sample within a short timeframe.
Preparation tips:
- 2–7 days without ejaculation
- No alcohol or strenuous physical activity for 48 hours beforehand
- No feverish infections in the last 2 weeks
- No sauna sessions or seat heating before handover
WHO reference values (2021)
The World Health Organization (WHO) publishes reference ranges for sperm analyses. "Normal" sperm quality is defined by:
- Sperm concentration: ≥16 million/ml
- Total number: ≥39 million
- Mobility (progressive): ≥30%
- Morphology (normally formed): ≥4%
- Ejaculate volume: ≥1.4 ml
- pH value: 7.2–8.0
Important: Even with slightly below-average values, pregnancy is still possible; the decisive factor is the interplay of all parameters and the health of the partner.
What does a poor sperm analysis mean?
An abnormal sperm analysis can have various causes, ranging from hormonal imbalances to environmental factors or genetic predisposition. Possible triggers:
- Hormonal imbalances (e.g., low LH, FSH, or testosterone)
- Varicocele (varicose vein in the testicle), a frequently overlooked cause
- Infections or inflammation of the prostate or epididymis
- Overheating (laptop on lap, sauna, tight clothing, heated seats)
- Smoking, alcohol, stress, lack of sleep
- Zinc, selenium, or vitamin D deficiency
- Anabolic steroids in the past
Depending on the diagnosis, targeted therapies can help through medication, surgery, or lifestyle changes.
Semen analysis and hormones: What else is part of the diagnostic workup?
An abnormal sperm analysis should never be considered in isolation. Instead, it is recommended to combine it with a comprehensive hormone panel , e.g., with:
- Testosterone (total and free)
- LH and FSH
- Estradiol, SHBG, DHEA
- Prolactin
- TSH, fT3, fT4 (thyroid)
This helps determine whether, for example, primary testicular insufficiency , a central pituitary gland problem , or a metabolic disorder is present. A more in-depth endocrine analysis should be considered, especially in cases of abnormal FSH or low testosterone levels.
Is it possible to improve sperm quality?
Yes, in many cases spermatogenesis can be influenced, as sperm production takes about 72 days and responds well to lifestyle changes. Tips:
- Regular exercise (especially strength training)
- Abstaining from smoking and alcohol
- Optimize sleep hygiene (at least 7 hours of sleep)
- Zinc, vitamin D, omega-3, coenzyme Q10, selenium
- Stress reduction , e.g. through mindfulness, relaxation, therapy
- Do not place laptops and mobile phones directly on your lap.
Conclusion
A semen analysis is not just a snapshot of your fertility, but a biomarker for your overall hormonal and metabolic health . Men who are serious about family planning or simply want to understand themselves better should know their sperm quality.
Whether due to an unfulfilled desire to have children, after a vasectomy or as part of a holistic health check: The sperm analysis is part of the basic diagnostics of modern men's health and is often the first step towards more self-determination and clarity.
