What is a Sperm Analysis (Spermiogram)?

Today, half of the couples' struggles with infertility originate from the male partner. The first and most crucial step in evaluating male reproductive health is the sperm test. Known medically as a "spermiogram" or "semen analysis," this test provides a detailed examination of the count, motility, structure, and other characteristics of sperm cells within the semen. In this article, you will find everything you need to know about the sperm test: what it is, why and when it is performed, how it is conducted, what the results mean, and more.

What Is a Sperm Test?

A sperm test is a microscopic laboratory examination performed to evaluate a man's reproductive potential. This test analyzes sperm cells within a semen sample obtained via ejaculation, assessing various parameters. The primary objective of the test is to determine whether the semen is suitable for conception. The spermiogram is considered the gold standard for diagnosing male infertility and serves as a guide in planning the treatment process.

Why and When Is a Sperm Analysis Performed?

A sperm test is generally requested in the following situations:

• Infertility Assessment: It is requested to evaluate a man's reproductive function if pregnancy has not been achieved despite one year of regular, unprotected sexual intercourse. If the female partner is over the age of 35, this timeframe is reduced to six months.
• Varicocele Monitoring: A varicocele-an enlargement of the veins in the testicles-can negatively affect sperm production. Sperm testing is used to monitor patients who have been diagnosed with a varicocele or have undergone surgery for it.
• Post-Vasectomy Check: A vasectomy is a surgical procedure that prevents pregnancy by tying off the sperm ducts. To confirm the procedure's success, sperm tests are performed at specific intervals to check for the presence of any remaining sperm cells in the semen. Before IVF Treatment: It is essential to determine a man's sperm quality before commencing assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
• General Reproductive Health Check: Men who wish to have their general reproductive health assessed-even in the absence of specific complaints-may also undergo this test.

How to Prepare for a Sperm Test?

Proper preparation is crucial for obtaining accurate results from a sperm test. Key points to consider before the test include:

Sexual Abstinence: You should abstain from sexual activity for a period of 2 to 7 days prior to the test. During this time, neither sexual intercourse nor masturbation should take place. Abstinence lasting less than 2 days may reduce sperm count, while abstinence exceeding 7 days can negatively affect sperm motility.

Alcohol and Smoking: Alcohol consumption should cease at least 48 hours before the test. Limiting the intake of cigarettes and caffeine is also recommended.

Medication Use: Be sure to inform your doctor about any medications or supplements you take regularly, as certain drugs can affect sperm parameters.

Infections and Febrile Illnesses: Recent febrile illnesses or infections (occurring within the last few weeks) may temporarily influence test results. It is important to discuss this with your doctor.

How Is a Sperm Sample Provided?

A sperm sample is typically provided in a private, quiet room within a laboratory or hospital, specifically designed for this procedure. The process for providing the sample is as follows:

1. Hygiene: Before providing the sample, hands must be thoroughly washed and rinsed with soap and water. This prevents the sample from becoming contaminated with bacteria.
2. Sample Container: You will be provided with a sterile container by the laboratory. You must collect the sample inside this container.
3. Masturbation Method: The sample is obtained via masturbation. Substances such as soap, lubricants, creams, or saliva must strictly not be used during this process. Such substances can impair the viability and motility of sperm cells, potentially leading to misleading test results.
4. Collecting the Entire Sample: It is crucial to collect the entire ejaculate (semen) in the container. The initial portion of the semen (the first few drops) is particularly rich in sperm concentration; losing this part can significantly affect the test results.

Which Parameters Are Evaluated in a Semen Analysis and What Are the Normal Values?

A semen analysis (spermiogram) evaluates a range of both macroscopic (visible to the naked eye) and microscopic (evaluated under a microscope) parameters. According to the reference values published in the World Health Organization (WHO) 2021 guidelines, the main semen parameters and their lower reference limits are as follows:

Interpretation of Sperm Test Results

Abnormal values are significant when interpreting test results. Certain medical terms are used when results fall below reference values:

• Oligospermia: Low sperm count (less than 16 million/ml).
• Asthenospermia: Low sperm motility (total motility <42% or progressive motility <30%).
• Teratospermia: Low percentage of normally shaped sperm (<4%).
• Oligoasthenoteratospermia (OAT): Low values across all three parameters: sperm count, motility, and morphology.
• Azoospermia: The absence of sperm cells in the semen. Further testing is required in this case.
• Aspermia: The absence of any ejaculate.

It should be noted that a single sperm test result showing values below the normal range is not sufficient for a definitive diagnosis of infertility. Since sperm production can be influenced by various factors, it is generally recommended to perform at least two tests spaced 1-3 months apart and to evaluate the results collectively.

Why is Sperm Morphology Important?

Morphology, or the shape of the sperm, directly affects its fertilization capacity. For sperm to fertilize an egg, it must have an ideal head, neck, and tail structure. A stricter evaluation method called the Kruger Criteria examines sperm shape in detail. In this method, only sperm with a perfect structure are considered "normal." According to the Kruger criteria, a normal morphology above 4% suggests a higher chance of pregnancy naturally or through artificial insemination (IUI). In cases of low morphology, treatments such as in-vitro fertilization (IVF) or intrauterine insemination (ICSI) may come to the forefront.

What Factors Affect Sperm Quality?

Sperm production and quality can be significantly affected by lifestyle and environmental factors:

• Smoking and Alcohol: Negatively affect sperm count, motility, and morphology.
• Obesity: High body mass index can disrupt hormonal balance and reduce sperm quality.
• Stress: Intense and chronic stress can affect the hormones that regulate sperm production.
• Excessive Heat: The testicles need to be a few degrees cooler than body temperature. Frequent hot baths, saunas, wearing tight underwear, and using a laptop on your lap can negatively affect sperm production.
• Nutrition: A diet rich in antioxidants, vitamins (C, E, B12), minerals (Zinc, Selenium), and Omega-3 fatty acids supports sperm health.
• Infections: Sexually transmitted diseases or other infections in the urogenital system can impair sperm quality.
• Environmental Toxins: Exposure to pesticides, heavy metals, and chemicals can damage sperm production.

What to Do After an Abnormal Sperm Test Result?

There's no need to panic if you receive an abnormal sperm test result. A urologist or andrologist will take additional steps to assess the situation:

1. Repeat Test: The test is usually repeated after a few months to confirm the result.
2. Physical Examination: The doctor will perform a detailed genital examination to detect varicoceles or other structural problems.
3. Hormone Tests: Blood tests will check the levels of hormones that play a role in sperm production, such as testosterone, FSH, and LH.
4. Genetic Tests: If necessary, blood tests (karyotype analysis, Y-chromosome microdeletion) may be ordered to investigate genetic problems that could cause infertility.
5. Scrotal Ultrasound: An ultrasound may be performed to provide a detailed view of the testicles and surrounding tissues.

Treatment Options for Male Infertility

Based on the results of sperm tests and other examinations, a treatment plan is created to address the underlying cause:

• Lifestyle Changes: Changes such as weight loss, quitting smoking and alcohol, balanced nutrition, and regular exercise can improve sperm quality.
• Medications: Hormonal deficiencies or infections can be treated with medication. Antioxidant supplements may also be recommended.
• Surgical Interventions: Problems such as varicoceles or blockages in the sperm ducts can be corrected surgically.
• Assisted Reproductive Techniques: Insemination (IUI): The process of selecting motile sperm and placing them into the uterus.

1. In Vitro Fertilization (IVF): The fertilization of an egg and sperm in a laboratory environment.

2. Intracytoplasmic Sperm Injection (ICSI): The injection of a single healthy sperm directly into the egg under a microscope. This is the most effective method, especially in cases of severe male infertility.

3. Surgical Sperm Retrieval (TESE/MESA): In cases of azoospermia, this is the surgical retrieval of sperm from the testicles.

Frequently Asked Questions (FAQ)

1. When are sperm test results available?

Results are usually available within 2-3 hours on the same day, depending on the workload of the laboratory where the test is performed.

2. Is the sperm test painful?

No, the sperm test is a completely painless procedure. It simply requires providing a sample via masturbation.

3. Can a sperm test be performed at a public hospital?

Yes, sperm tests are performed in laboratories affiliated with the urology and gynecology departments of public hospitals.

4. What is the cost of a sperm test?

(As of 2026) Sperm test prices may vary depending on the city, the type of hospital (public or private), and the scope of the test.

5. Can a sperm test be done at home?

There are some simple test kits available on the market for home use. However, these kits generally measure only sperm count and do not provide critical information such as motility and morphology. To diagnose infertility, it is essential to undergo a comprehensive spermiogram test at a laboratory.

Where Should I Have a Semen Analysis Performed?

For this reason, it is important to carefully choose a reliable and experienced center when deciding where to have a semen analysis performed.The sperm test (spermiogram) is a cornerstone of male reproductive health. Although it is a simple, painless, and non-invasive test, it offers invaluable information regarding a man's fertility potential. If you have concerns about having children, undergoing this test by consulting the expert physicians and laboratory team at the Bursa Eurofertil IVF Center is the most important step toward an accurate diagnosis and appropriate treatment.