sperm counts are measured in 3 main ways

count (concentration

  • 15 million/ml or more is considered fertile
  • 39 million/ejaculate or more is considered fertile

motility (movement)

  • total motility 40% or more is considered fertile
  • progressive motility of 32% or more is considered fertile

Total motility combines progressive motility which means the sperm are actively swimming in a line or large circle, and non-progressive motility which means movement without progression, for example swimming in small circles.

morphology (shape)

  • a minimum of 4% of the sperm need to be of a normal shape to be considered fertile (WHO, 2010)
  • sperm with normal morphology of less than 4% is likely to need help with ICSI 

The WHO guidelines for grading morphology were updated in 2010 so any results prior to that may state normal morphology to be 15%.  All clinics and laboratories now use the new reference range, but older websites may still refer to previous guidelines which can be confusing.  You may also see Kruger Strict criteria on your lab report - this is a way of assessing sperm morphology which focusses on the likelihood of the sperm succeeding in fertilising the egg.

why you should have more than one semen analysis

According to 2013 NICE guidelines a single sperm analysis can give false abnormal results in 10% of men, but repeating the test reduces this to 2%   The guidelines also state that false abnormal results are more likely to occur than false normal - so if your result is normal there is no need to repeat. 

about MAR and anti-sperm antibodies

Some laboratories will also give a result for MAR IgA and IgG.  This stands for Mixed Antiglobulin Reaction and looks for the presence of proteins called immunoglobin A and G.  A positive test indicates the presence of anti-sperm antibodies and this can affect the sperm's ability to penetrate cervical mucous and fertilise the egg.  Anti-sperm antibodies are an immune reaction which sometimes happens when there has been a history of inflammation, infection, injury or surgery to the testes. 

comprehensive semen analysis test

The Doctors Laboratory in London offer a Comprehensive Semen Analysis and this includes count, motility, morphology according to Kruger strict criteria, and MAR.  More detailed information including what the results might indicate is available at 

http://www.tdlpathology.com/services-divisions/tdl-andrology/a-comprehensive-semen-analysis    

additional tests on sperm

These include DNA fragmentation, sperm aneuploidy and oxidative stress which may give useful information but are not included in routine sperm tests - for more info click here
 

references

National Institute for Health and Care Excellence (2013) [Fertility: Assessment and treatment for people with fertility problems]. {CG156]. London: National Institute for Health and Care Excellence. http://www.nice.org.uk/nicemedia/live/14078/62770/62770.pdf

WHO Laboratory manual for the examination and processing of human semen, 5th edition (2010)http://whqlibdoc.who.int/publications/2010/9789241547789_eng.pdf