In almost half of all couples having difficulty achieving pregnancy, there are abnormalities in the sperm parameters. For this reason, it is important that the male partner undergoes a formal semen analysis to assess whether there is an adequate sperm number and quality. The doctor may advise the man who is scheduled for a semen analysis to abstain from sex for two to four days prior to the test.

The semen analysis will include basic parameters such as the sperm number (concentration), motility (how many are moving), and morphology (the microscopic shape). A normal sperm number (concentration) is greater than 20 million/mL. The technician looks at how well the sperm are moving and counts the total percentage of moving sperm (motility). At least 50% of any given sperm population should be moving. Finally, the shape or morphology of the sperm is determined.

In the event that the semen analysis is abnormal, it should be repeated, and referral to an urologist who specializes in male infertility will be considered. Evaluation of the male partner involves a thorough physical examination and hormonal testing. In the event that no sperm at all are found on a semen analysis, more sophisticated methods to search for sperm may be advised in consultation with an urologist.