Semen analysis: Introduction, Physical, chemical, microscopic examination, normal range of sperm count and clinical significance

sperm under microscope during semen analysis

Introduction of  Semen analysis

Semen is a grey opalescent fluid that forms at ejaculation. It consists of a suspension of spermatozoa in seminal plasma. Semen analysis uses to check the reproductive status of a person. It is necessary to note the following points while reporting for routine semen examination.

  1. Abstinence  days (Obtain the semen analysis  at least 3 days of abstinence from coitus)
  2. Method of sample collection
  3. Time and place of sample collection

Collection and examination time is also necessary for semen analysis. Semen should examine within 30 minutes.

Physical  examination

Colour and appearance: Greyish-white, viscid, opaque (normal finding)

Clinical significance

Increased turbidity may associate with inflammatory processes in some parts of the reproductive tract.

Viscosity: The specimen of normal viscosity can be poured drop by drop.

Clinical significance

Increased viscosity is concerned with the poor invasion of the cervical mucus in post-coital studies. Absence of viscosity points to reduced cell content.

Volume: 2-5 ml (normal finding)

Clinical significance

A lesser amount may arouse suspicion of deficiency and premature weakening by vaginal acidity.

Liquefaction time: 20-30 minutes (normal finding)

Clinical significance

Failure to liquefy within 30 minutes may associate with infertility. The semen from males with bilateral congenital absence of the vas deferens and seminal vesicles fails to coagulate due to the absence of coagulation substrate.

Chemical examination

pH: 7.2-7.8 (normal finding)

Clinical significance

pH values less than 7.0  are frequently associated with semen consisting largely of prostate secretions due to congenital aplasia of the vasdeferens and seminal vesicles.

Fructose: 150-300 mg/dl (normal finding)

Clinical significance

Disorders of seminal vesicles may lead to reduction in fructose concentration. There is an inverse relationship between fructose level and sperm count. High fructose values associated with low sperm count.

Microscopic examinations

Sperm count: 40-300 millions/ml (normal value)

Clinical significance

The complete absence of spermatozoa is called azoospermia. A reduced number is termed oligozoospermia.

related clinical conditions:

mumps, orchitis, prostatitis, occlusion or absence of efferent ducts, hypopituitarism, hypogonadotropic hypogonadism. The sperm count may be low in estrogen secreting tumors and in hypo-and hyperthyroidism.

Motility after 2 hours, 3 hours, and 6 hours: 60-95% (normal finding)

Clinical significance

Motile forms decrease by about 5% per hour after the fourth hour following collection. Motility less than 60% may be associated with infertility.

Abnormal forms: 0-20%

Clinical significance

More than 20% of abnormal forms may be associated with infertility.

Following abnormalities in spermatozoa are observed.

Heads: too small, too large, double heads, pointed heads, ragged heads

Middle piece: absent, bifurcated, or swollen.

Tails: double, curved, rudimentary, or absent

pus cells: 1-2/ HPF (normal finding)

Clinical significance

Increased number of pus cells-Inflammation due to infection in some parts of the reproductive system. Infection of the seminal vesicle.

Epithelial cells: 1-2/HPF (normal finding)

Clinical significance

Increased number: not significant

Red blood cells: Absent (normal finding)

Clinical Significance

Tuberculosis of seminal vesicle, rupture of the blood vessel, infection of the prostate, vitamin C deficiency.

Trichomonas: Absent (normal finding)

Clinical significance

Trichomonas infection i.e. motile flagellate with pus cells


  1. Textbook of Medical Laboratory Technology
    by Praful B. Godkar, Darshan P. Godkar
  2. Textbook of Medical Laboratory Technology by Ramnik Sood (2006)
  4. analysis
  7.  sfvrsn=5227886e_2

[13528 visitors]


© 2023 | All Rights Reserved