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Semen Analysis: A Quick Reference Guide
In 2010, The World Health Organization (WHO) released the Laboratory Manual for the Examination and Processing of Human Semen: Fifth Edition. Interpreting a semen analysis report, for the average couple, is confusing and leaves many of us scouring the internet to see what it all means.
Here’s a quick reference guide that will help you feel less like you’re studying rocket science and more equipped to talk sperm like the pros.
According to the WHO’s Fifth Edition:
- Volume: 1.5ml or greater is normal
- Total Sperm (millions in ejaculate): 39 million or greater is normal
- Concentration AKA Count (millions per ml): 15 million or greater is normal
- Motility: 40% or greater is normal
Now here is the tricky part. There are two scales for measuring morphology. The WHO criteria is based on population studies that took the average morphology of groups of men who were able to get their partner pregnant within the last year of being surveyed. Kruger strict criteria looks at the functionality of normal appearing sperm. Most clinics today are moving toward Kruger strict criteria, so your semen analysis will likely be based on that scale.
- Morphology by WHO standards: 30% or greater is normal
- WHO standard for Kruger strict 4% or greater is normal
At this point, you are either breathing a sigh of relief or wondering what treatment options are available to you. Keep in mind that sperm reproduce approximately every 3 months, so there is potential for improvement. You should discuss supplements and treatments for improving sperm with your fertility doctor or urologist.
Luckily, most fertility treatments take the matter of sperm into their own hands rather than leaving it up to Mother Nature. In the case of Intrauterine Insemination (IUI) or in vitro fertilization (IVF), sperm is washed post-collection, and only the gold medal winners are used for the procedure.
In instances of significant male factor infertility or problems with egg penetration, a process called Intracytoplasmic sperm injection (ICSI) -“ick-see” for short, is utilized. One sperm is injected into each egg by a highly trained lab technician. ICSI is a highly successful procedure and is offered as standard protocol in many clinics across the country.