Guidelines for collection:
- Ejaculation, within one hour of specimen analysis
- Ideally at laboratory site after masturbation, into a clean wide mouthed contained
- If at home, transported to lab within one hour, kept at body temperature (i.e. in pocket)
- Minimum of 2 x separate analyses, at least 6 weeks apart (transient illnesses etc may affect results)
- Toxin free condoms available for those who can’t masturbate due to cultural reasons
- First part of semen contains most sperm
- Should be abstinent for 2 – 5 days from last ejaculation, with that information recorded
- Period of abstinence should be similar for patient on different samples
WHO 2021 reference ranges
Volume > 1.4 mL (practically < 1 mL is common cutoff, 2010 was 1.5)
pH > 7.2
Concentration > 16 x 106 (16 million) / mL (was 15 in 2010)
Total number > 39 x 106 / ejaculate
Motility > 30 % with progressive motility (was 32 in 2010)
Morphology > 4 %
Vitality > 54 % (was 58 in 2010)
White cells < 1 million / mL
Azoospermia No sperm
Cryptozoospermia So few it is difficult to measure
Oligospermia Low sperm density
Asthenospermia Low sperm motility
Teratospermia Overabundance of abnormal sperm
Necrospermia Too many dead sperm
Oligoasthenoteratospermia (OAT) Defects in density, motility and morphology combined
If low or zero semen volume – a post ejaculatory urine analysis can be performed to identify the presence of retrograde ejaculation.
The patient should void prior to masturbation and the semen from masturbation collected.
They should then void after ejaculation and this should be collected in separate pot.
If needing to collect sperm for ART in the setting of retrograde ejaculation – patient needs to provide alkalinised post ejaculatory urine sample.
- Normally acidic urine is spermicidal
- Sodium bicarbonate taken night before and morning of collection