You’re holding your first semen analysis report and wondering: “Are my numbers good?” This question is on the mind of every man who thinks about his fertility. Here you’ll find out what the numbers mean and which values are actually relevant.
The good news first: A single semen analysis is only a snapshot. Your fertility depends on many factors. The bad news? Many men completely misinterpret their results.
This guide shows you which parameters really matter and when you should start to worry.
Overview of all semen analysis parameters
A semen analysis examines your ejaculate according to standardized criteria. Each parameter provides information about a different aspect of your sperm production and function.
Macroscopic parameters
The first values are determined with the naked eye or simple tools. The volume shows how much seminal fluid you produce. Too little can point to problems with the seminal vesicles. Too much is usually not a problem.
The pH reflects the acid-base balance. According to the WHO, a value below 7.2 can indicate that the alkaline secretion of the seminal vesicles is missing. The liquefaction time is crucial: If the semen does not liquefy properly, sperm stay “trapped.”
The viscosity describes how thick your semen is. Think honey versus water. If it is too thick, it hinders motility.
Microscopic parameters
Here it gets interesting. The sperm concentration shows how many sperm are swimming per milliliter. Multiplied by the volume, you get the total sperm count. According to the WHO, it is more informative than the concentration alone.
Motility is divided into different types of movement:
- Progressive motility: swimming forward, since 2021 again divided into fast and slow progressive
- Non-progressive motility: movement without moving forward, such as in place or in circles
- Immotile: no movement
Morphology and other parameters
Morphology assesses the appearance of the sperm. Are the head, midpiece, and tail normally shaped? The assessment follows very strict criteria. That is why even 4% normally shaped sperm are considered normal.
Vitality shows how many sperm are still alive. Sometimes living sperm are only temporarily immotile.
Leukocytes are white blood cells. Too many point to inflammation. The MAR test and the immunobead test look for antibodies that attack your own sperm.
Reference values according to the WHO 2021 standards
The World Health Organization updated its reference values in 2021 with the 6th edition of its laboratory manual. They are based on data from around 3,500 men from 12 countries whose partners became pregnant within 12 months.
| Parameter | WHO reference value 2021 | Earlier values (2010) |
|---|---|---|
| Volume | ≥ 1.4 ml | ≥ 1.5 ml |
| Sperm concentration | ≥ 16 million/ml | ≥ 15 million/ml |
| Total sperm count | ≥ 39 million | ≥ 39 million |
| Progressive motility | ≥ 30% | ≥ 32% |
| Total motility | ≥ 42% | ≥ 40% |
| Normal morphology | ≥ 4% | ≥ 4% |
| Vitality | ≥ 54% | ≥ 58% |
pH and leukocytes are not in the 2021 reference table. A pH below 7.2 and many white blood cells are, however, findings that should be investigated further.
What do these adjustments mean?
The new values are in part less strict (volume, progressive motility, vitality) and in part somewhat stricter (concentration, total motility). Most importantly, the limits are the 5th percentile of the reference group. According to the WHO, they are expressly not a dividing line between fertile and infertile men. Even men with supposedly “worse” values can become fathers.
Particularly interesting: The minimum required volume dropped to 1.4 ml. Many men worry about, say, 1.2 ml. That is below the reference value, but not automatically a problem.
Differences between countries
Germany, Austria, and Switzerland all follow the WHO laboratory manual. In practice, the assessment can still differ from lab to lab, for example when a report still uses the older 2010 limits. So check which reference values are on your report, and ask if you’re not sure.
Interpretation: normal, borderline, and critical ranges
The WHO values are lower limits, not optimal values. A simple traffic light system helps put them in context. It is based on the distributions in the WHO reference group, meaning men whose partner became pregnant within a year.
Green range: good values
Three out of four men in the WHO reference group reached these values (25th percentile):
- Volume: from 2.3 ml
- Concentration: from 36 million/ml
- Total count: from 108 million
- Progressive motility: from 45%
- Morphology: from 8%
As far as the semen analysis goes, you are in good shape with these values. That is not a guarantee of pregnancy, though.
Yellow range: borderline values
Between the WHO minimum and the green range, you are in the yellow range. The values are within the normal range but fall in the lower quarter of the reference group:
- Volume: 1.4 to 2.3 ml
- Concentration: 16 to 36 million/ml
- Total count: 39 to 108 million
- Progressive motility: 30% to 45%
- Morphology: 4% to 8%
Here, repeating the test after 2 to 3 months makes sense. Whether vitamins for fertility improve the values is not clearly proven, but the topic is still worth a look.
Red range: critical values
Below the WHO reference values, things get difficult:
- Volume: < 1.4 ml
- Concentration: < 16 million/ml
- Total count: < 39 million
- Progressive motility: < 30%
- Morphology: < 4%
But note: Natural pregnancies are possible here too! Statistically less likely, but not impossible.
Extreme values and what they mean
Azoospermia means there are no sperm in the ejaculate. It sounds dramatic. But it is often treatable. Sometimes sperm are hiding in the testicles.
Oligozoospermia means too few sperm, that is, a total count below 39 million or a concentration below 16 million per milliliter. The lower the values, the harder it gets by natural means, but modern methods such as ICSI can help.
Asthenozoospermia: poor motility, meaning fewer than 30% progressively motile sperm. Possible causes include inflammation, but the cause often remains unclear.
Teratozoospermia: too many abnormally shaped sperm, meaning fewer than 4% normal forms.
Understanding combination effects
It is not uncommon for several parameters to be affected at the same time:
- Oligoasthenozoospermia: few sperm with poor motility
- Oligoasthenoteratozoospermia: few sperm with poor motility and abnormal shape
The more parameters are affected, the more complex the treatment becomes. But there is no reason to despair.
What do deviations mean for fertility?
The crucial question: Can I still become a father? The answer is almost always: Yes. The path can differ, though.
Natural pregnancy
How high the chance of pregnancy per cycle is depends heavily on your partner’s age and many other factors. Good semen analysis values improve the starting point but guarantee nothing.
With borderline values, many couples still succeed, but it sometimes just takes longer. Patience and a healthy lifestyle pay off.
With values below the WHO limits, the chances can be lower. If pregnancy does not occur after 12 months, the guideline of the European Association of Urology (EAU) recommends having both partners evaluated. This is the point to consider getting support.
When is assisted reproduction necessary?
IUI (intrauterine insemination): With mild impairments, placing prepared sperm directly into the uterus can help. A prerequisite is enough motile sperm after preparation.
IVF: With moderate problems, eggs are fertilized outside the body. Often fewer sperm are enough here.
ICSI: The most advanced option. A single sperm is injected directly into the egg. Possible even with extreme impairments. You can find more in our ICSI vs. IVF comparison.
Don’t forget age effects
Is your partner over 35? Then other factors also play a role. Time becomes more precious, even with good semen analysis values.
Lifestyle factors: what you can do yourself
Poor values are not set in stone. According to the EAU guideline, losing weight, exercising more, quitting smoking, and drinking less alcohol can improve sperm values:
Diet: A balanced diet is the foundation. Antioxidants, zinc, or selenium are often recommended, but the evidence on them is contradictory.
Exercise: According to a meta-analysis, regular exercise is associated with better sperm values, and this applies to moderate as well as more intense recreational activity.
Sleep: Make sure you get enough, regular sleep. It is good for your hormone balance and your general well-being.
Stress: Whether stress directly worsens sperm quality has not been clearly proven. Relaxation is good for you, your relationship, and how you cope with trying to conceive, though.
Smoking and alcohol: Smoking is clearly linked to poorer sperm values. Moderate alcohol consumption does not seem to worsen the values, but heavy drinking does. Abstaining is worth it.
Identifying medical causes
Sometimes treatable conditions are behind it:
- Varicocele: varicose veins around the testicle
- Infections: often without symptoms
- Hormonal disorders: check testosterone, FSH, LH
- Medications: some affect sperm production
Timing of the test
A semen analysis is only a snapshot. The maturation process of new sperm takes a little over three months. An illness, especially with fever, or medications from that period can still have an effect.
That is why the rule of thumb is:
- For borderline or abnormal results: repeat after 2 to 3 months
- For critical values: further testing without delay
- For good values: a new check mainly if conception is delayed
Psychological aspects
Poor semen analysis values can weigh on the mind. A sense of masculinity and self-worth often suffer. That is normal, but it doesn’t help.
You are more than your sperm count. Modern medicine offers many solutions. The right fertility clinic makes the difference.
Considering costs
This section applies to Germany, Austria, and Switzerland.
The examination itself involves limited costs. Treatments can become more expensive:
Germany: For married couples, the statutory health insurance fund covers 50% of the costs for up to three IVF or ICSI attempts. Requirements include an approved treatment plan, a minimum age of 25, and age limits of 40 (woman) and 50 (man).
Austria: The IVF Fund (IVF-Fonds) covers 70% of the costs for up to four attempts if certain criteria are met, such as a recognized indication and the age limits.
Switzerland: Mandatory basic health insurance (Grundversicherung) pays for the evaluation and inseminations (a maximum of three cycles per pregnancy), but not for IVF and ICSI.
Long-term outlook
With modern methods such as ICSI, many men with severely impaired values also have a chance of having a child of their own. Even when no sperm can be found in the ejaculate, sperm can be retrieved directly from the testicle (TESE) in about half of cases of impaired sperm production.
Medicine is advancing rapidly. What seems impossible today may be routine tomorrow.
Frequently asked questions
Can a poor semen analysis improve on its own?
Yes, that is quite possible. New sperm mature in a little over three months. If you improve your lifestyle during this time, your values can recover.
According to the EAU guideline, losing weight, exercising more, quitting smoking, and drinking less alcohol can improve sperm values.
Temporary causes such as an illness with fever or certain medications often go away on their own. That is why, with borderline results, patience is often the best medicine.
How often should I repeat a semen analysis?
That depends on your values. With normal results, repeating the test is usually only necessary if conception continues to be delayed or new risk factors come up.
Abnormal or borderline results are usually rechecked after 8 to 12 weeks. Changes only show up in the results once newly formed sperm are present, so earlier checks are not very informative.
With critical values, or when treatment is coming up, closer monitoring makes sense. Sometimes special tests such as DNA fragmentation or the acrosome reaction can also be useful.
Do illnesses affect semen analysis values?
Yes. According to the WHO, it is mainly a recent illness with fever that affects the values. Because new sperm take a little over three months to mature, an illness can still show up in the semen analysis weeks later.
Chronic conditions such as diabetes, high blood pressure, or being very overweight can also affect fertility. That is why a thorough medical history belongs with every semen analysis evaluation.
Medications are often overlooked culprits. Some active ingredients can impair sperm production. Have an andrologist review your medication list.
Are expensive dietary supplements worth it for sperm quality?
Most overpriced “fertility pills” are a waste of money. A balanced diet normally covers all needs.
Zinc, selenium, or vitamin D can be useful, but mainly when a deficiency has been proven. A blood test shows what you really need.
Antioxidants such as vitamins C and E are supposed to reduce oxidative stress. Whether they improve the chance of having a child is not reliably proven, according to a Cochrane review and the EAU guideline; the studies are of low quality. Here, too, moderation applies. More is not always better.
Sources
- WHO laboratory manual for the examination and processing of human semen, 6th edition, World Health Organization, 2021
- Fertility tests in men, familienplanung.de (Federal Institute for Public Health), 2026
- Sperm and male fertility, familienplanung.de (Federal Institute for Public Health), 2026
- EAU Guidelines on Sexual and Reproductive Health: Male Infertility, European Association of Urology, 2026
- Antioxidants for male subfertility, Cochrane Database of Systematic Reviews (Smits et al.), 2019
- Section 27a, Social Code Book V (Sozialgesetzbuch V, SGB V): Assisted reproduction, Federal Ministry of Justice, as of 2026
- IVF Fund Act (IVF-Fonds-Gesetz), Federal Legal Information System (Rechtsinformationssystem des Bundes, RIS), as of 2026
- Health Care Benefits Ordinance (Krankenpflege-Leistungsverordnung, KLV), Annex 1 (edition of July 1, 2026), Federal Office of Public Health (BAG), 2026
