Semen Analysis Results: Discrepancies and Testing Methods Explained

Consult a medical professional?

Doctor, about 7 months ago, I had a semen analysis done at a laboratory.
I abstained for 5 days and collected the sample by masturbation into a paper cup.
The results were as follows: Appearance: grayish-white; Total volume: 4.5 cc; Liquefaction time: 25 minutes; pH: 8.5; Motility at 1 hour: 85%; Motility at 2 hours: 70%; Normal sperm morphology percentage: 87%; Red blood cells: 0-1; White blood cells: 1-2; Epithelial cells: 2-3; Sperm count: 31,000/cc.
Since my partner has not become pregnant, I went to another laboratory this month for another test.
I abstained for 7 days and collected the sample by masturbation into a condom.
The results were as follows: Reference values: Appearance: grayish-white; pH: 7.5; Total volume: 2.2 cc; Sperm count: 5,120/cc; Rapid motility: 65%; Slow motility: 14%; Non-motile: 21%; Normal sperm morphology percentage: 64%; Red blood cells: 1-2; White blood cells: 2-3; Epithelial cells: 0-1; Liquefaction time: 70 minutes.

I would like to ask the doctor why the reference values from the two laboratories are different.
Why is there such a significant difference in sperm count and normal sperm morphology percentage between the two reports? Is it due to the difference in abstinence duration? Why did the doctor in the second test tell me to collect the sample in a condom? Is that accurate? The key point is that although both results are normal, the reference values differ.
Should I get tested again?

eric, 20~29 year old female. Ask Date: 2011/06/16

Dr. Xu Wencang reply Urology

Hello; semen analysis requires a sexual abstinence period of at least 36-72 hours before collecting the sample.
The results can often vary significantly based on factors such as physical condition, whether the individual has stayed up late, consumed alcohol, taken hot baths, or worn tight clothing.
According to the World Health Organization's normal standards: total semen volume should be 2-5 cc, pH should be between 7.2-7.8, sperm concentration should be 20 million sperm per cc or more, total sperm count (sperm concentration multiplied by total volume) should be 40 million or more, motility should have at least 50% progressive motility or at least 25% rapid linear motility, and morphology should have at least 50% normal forms.
Although sperm count is important, motility and progressive movement are also crucial for fertility.
Based on your analysis results, they appear to be normal.

Reply Date: 2011/06/16

More Info

When it comes to semen analysis, discrepancies in results can often arise due to various factors, including the method of collection, the laboratory techniques used, and even the individual’s physiological state at the time of testing. Your situation highlights some of these complexities, and I will explain the key aspects that could contribute to the differences in your semen analysis results.

Factors Influencing Semen Analysis Results
1. Collection Method: The method of semen collection can significantly impact the results. In your first analysis, the sample was collected via masturbation into a paper cup, while in the second analysis, it was collected using a condom. The use of condoms can sometimes introduce substances that may affect sperm motility or viability, depending on the type of condom used. For example, some condoms contain spermicidal lubricants, which can adversely affect sperm health. Therefore, it’s crucial to use non-spermicidal condoms if this method is chosen for collection.

2. Abstinence Period: The duration of abstinence before the test can also influence the results. You mentioned a 5-day abstinence period for the first test and a 7-day period for the second. Generally, a period of 2-7 days is recommended for optimal sperm quality. However, longer abstinence can lead to a decrease in sperm motility and an increase in the number of abnormal sperm, while shorter periods may not allow for optimal sperm maturation. The differences in abstinence could contribute to variations in sperm count and motility.

3. Laboratory Techniques: Different laboratories may use varying techniques and equipment for analyzing semen. This can lead to discrepancies in reported values. Each lab may have its own reference ranges based on the population it serves, which can also account for differences in results. It’s essential to compare results from the same laboratory whenever possible to ensure consistency.

4. Physiological Variability: Individual factors such as stress, illness, diet, and hydration can affect semen quality. If there were any changes in your health or lifestyle between the two tests, this could also explain the differences in results.

Understanding Your Results
- Sperm Count: Your first test showed a sperm count of 31,000/cc, while the second test reported 5,120/cc. The first result is above the World Health Organization's lower reference limit of 15 million sperm per milliliter, while the second result is below this threshold, indicating oligospermia (low sperm count). This significant difference could be due to the factors mentioned above, particularly the collection method and abstinence period.

- Sperm Motility: The motility results also vary, with the first test showing 85% motility in the first hour and 70% in the second hour, while the second test reported 65% rapid motility, 14% slow motility, and 21% immotile sperm. This variation could again be influenced by the collection method and the time elapsed before analysis.

- Sperm Morphology: The normal morphology percentage was 87% in the first test and 64% in the second. A higher percentage of normal forms is generally favorable, but variations can occur based on the factors discussed.

Next Steps
Given that both tests returned results within the normal range for some parameters, it may not be necessary to retest immediately. However, if you and your partner are experiencing difficulties with conception, it may be beneficial to consult with a fertility specialist. They can provide a comprehensive evaluation and may recommend further testing or interventions based on both partners' health.

In conclusion, while the discrepancies in your semen analysis results can be concerning, they are not uncommon. Factors such as collection method, abstinence period, and laboratory differences can all play a role. It’s advisable to discuss these results with a healthcare provider who can guide you on the next steps and any further evaluations that may be necessary.

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