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A guide to testing your sperm count and quality
Men’s reproductive health is just as important as female reproductive health when trying to conceive. Male factor infertility will contribute to around 50% of all cases where a heterosexual couple struggles to become pregnant.
Understanding your reproductive health isn’t always easy, but it is paramount to obtaining a full picture of your circumstances and the family planning options you have. A sperm analysis is often a good place to start.
In this guide, we explain what a sperm analysis tells you about your sperm health, where you can have a sperm test in the UK, and the next steps if you get an abnormal sperm test result.
What is a sperm analysis test?
A sperm analysis, or semen analysis test, is a test carried out in a laboratory that evaluates a man’s fertility by evaluating key parameters of a semen sample.
It is used to investigate fertility issues, and sperm analysis results can help inform lifestyle changes and determine suitable treatment options. A basic sperm analysis test will usually:
Check sperm count
A sperm count looks at how many sperm are present in the semen. While only one sperm cell is needed to fertilise an egg, a higher count means more sperm are available for this to happen. Sperm count results can be given in two formats:
- Sperm concentration: the number of sperm per millilitre of semen
- Total sperm count: The total number of sperm in an entire semen sample
According to World Health Organisation reference guidelines, a normal sperm count is defined as at least 16 million sperm per millilitre or a total count of more than 39 million.
For more information on sperm count, read our guide to signs of a low sperm count.
Check sperm motility
Sperm motility refers to how sperm move. The ability to travel forward is a crucial factor in sperm being able to fertilise an egg. The World Health Organization classifies sperm motility into four categories: rapid progressive, progressive, non-progressive and immotile.
In our current testing, sperm motility is reported across three categories:
- Progressive motility: Sperm that swim in a straight line or large circles.
- Non-progressive motility: Sperm that are moving but not making forward progress. They may wriggle in place or move in tight circles.
- Immotile: Sperm that show no movement at all.
A semen analysis evaluates the progressive motility of sperm. According to guidelines published by the World Health Organisation, a normal sperm motility is when at least 30% of the sperm in a sample have progressive motility.
Find out more with our sperm motility guide.
Check sperm morphology
Sperm morphology relates to the size, shape and structure of sperm cells. Their morphology is important for movement and for being able to fertilise an egg.
It is normal for most sperm in a sample to be misshapen. They may have large or small heads, stunted or double tails, or other structural issues. Fortunately, only a small number of regularly shaped sperm are needed to conceive.
During a semen analysis, a specialist will examine the appearance of sperm cells under a microscope and calculate the percentage of normal forms in the sample. A result of 4% or more normal forms is considered to be within the normal range.
Learn more about sperm morphology.
Check semen pH
pH refers to how acidic or alkaline a substance is. Semen should be slightly alkaline to help protect sperm as they travel through the vagina, which is naturally more acidic. The ideal pH range for semen is 7.2 to 8.0.
Check semen volume
The amount of semen a man produces can vary per ejaculation, but semen volume is an important factor in fertility, as an adequate amount is needed to successfully carry the semen through the female reproductive system.
A normal semen volume is considered to be 1.3-1.5 millilitres, and it is measured by pouring a liquefied semen sample into a measuring cylinder.
Check for sperm vitality
Live sperm are needed for conception; however, it is normal for some sperm not to be living in a semen sample. Sperm vitality determines the percentage of living sperm in a semen sample, and a normal sperm vitality result is between 50 and 56% live sperm.
Can you get an NHS sperm test?
Yes, men can get a test on the NHS to determine sperm count and quality, and it is typically free of charge.
If you are concerned about your fertility or have been trying to conceive for more than 12 months without success, the first step is to talk to your GP. They can refer you to a hospital’s fertility or andrology department for a semen analysis.
Once they receive your referral, the hospital will arrange an appointment for you and provide instructions on how, when and where to produce your semen sample. Many hospitals will require you to produce a sample in a private sample room on site, although others will provide the necessary equipment and allow you to produce a sample at home and then bring it to the hospital.
Are home sperm test kits reliable?
There is a range of companies that offer at-home sperm test kits. It may seem like an easy and less daunting way to find out more about your fertility, but it’s important to be aware of their limitations.
Most home sperm tests focus on sperm count. While this can give you a broad indication of your fertility, it doesn’t tell the full story and could mean you miss something that is a critical factor contributing to fertility issues.
Another consideration is accuracy. Although some kits are approved for home use and can provide a general result, they aren’t as reliable or detailed as a laboratory analysis. Variables like how the sample is collected, stored, and tested can also affect the results. For example, temperature changes or delays in testing could skew the outcome.
Where can you get a private sperm test?
You can get a private sperm test at a licensed fertility clinic, a private hospital, or through a private health provider, such as one that may be accessible through your employee benefits programme.
There are also some companies that offer laboratory standard semen analyses by sending out a kit so that you can produce a sample, before then returning it to them by post. However, you should always check their credentials, read reviews, and check that their processes are compliant with regulations.
How much does a private sperm test cost?
The cost of a private semen analysis will depend on which provider you use and the extent of the testing done. A basic semen analysis can cost between £120 and £300, with specialised tests incurring separate additional costs.
What is a sperm DNA fragmentation test?
A sperm DNA fragmentation test looks at the integrity of the genetic material within sperm. While a standard semen analysis focuses on count, motility, and shape, it doesn’t assess the quality of the DNA each sperm carries, a key factor in fertilisation, embryo development, and pregnancy success. High levels of DNA fragmentation can make it harder for sperm to fertilise an egg or may increase the risk of early miscarriage.
This test measures the percentage of sperm with damaged DNA; generally, a fragmentation rate below 15% is considered normal, while rates above 25% may indicate reduced fertility potential.
This type of test can be especially useful if your semen analysis appears normal, but conception has been difficult, or if there’s a history of recurrent pregnancy loss.
What is a sperm oxidative stress test?
A sperm oxidative stress test measures the balance between reactive oxygen species (ROS)/ free radicals, unstable molecules that can damage cells, and antioxidants in the semen. Excessive oxidative stress can harm the sperm membrane and DNA, affecting motility and the sperm’s ability to fertilise an egg.
The test helps identify whether oxidative damage may be contributing to fertility problems, even when standard semen parameters are within normal ranges. Ideally, results should show low oxidative stress levels, indicating that sperm are well protected from oxidative damage.
This test can be particularly informative for men with unexplained infertility, lifestyle risk factors such as smoking or high stress, or after repeated unsuccessful fertility treatments.
What does it mean if you get an abnormal sperm test result?
An abnormal sperm test result may indicate there is an issue with one or more of your semen parameters, which could affect your fertility. A follow-up test is often recommended to confirm the results, as sperm production can vary.
The results won’t necessarily reveal the underlying cause of low sperm count, motility or morphology, but can help inform further investigations and possible treatments.
Abnormal results can understandably feel worrying, but they don’t always mean the issue is permanent or that you won’t be able to conceive in the future. Sperm quality can often improve with lifestyle changes, medical treatment, or time.
However, if tests suggest that natural conception is unlikely, there are still many ways to build a family. Fertility treatments such as IVF or ICSI, as well as options using donor sperm, can offer hopeful alternatives and help you take the next step towards parenthood.
If donor sperm IVF is something you’re considering, we partner with London Women’s Clinic and Kind iVF; two exceptional fertility care providers who have a wealth of experience in facilitating IVF cycles using donor sperm. At London Sperm Bank, we also support patients to find a donor that resonates with them and coordinate the delivery of donor sperm to your chosen clinic, ready for your treatment.
Do you need a sperm quality test to become a sperm donor?
Yes, all licensed sperm banks, including London Sperm Bank, require their donors to undergo a rigorous screening process, which includes a semen analysis. This is because donor sperm must be of high quality to give those using it the best possible chance of a successful pregnancy.
When it comes to choosing to donate sperm, each donor’s reasons are deeply personal but rooted in altruism and the desire to make a meaningful difference in the lives of others. The decision to donate is driven by the impact you can have, rather than any financial incentive.
If you’re interested in helping men who are diagnosed with infertility, same-sex female couples, and solo mothers realise their dreams of parenthood, find out more about how to become a donor.