Pu­blished: 9. Fe­bruary 2022 | Up­dated: 28. Au­gust 2023 Author: Jenia Chor­naya | Re­viewed by Jenia Chor­naya

The sper­mio­gram — fer­ti­lity test for men

We reveal how a sper­mio­gram works, what the re­sults can be and what men can do to im­prove their sperm qua­lity.

What is a sper­mio­gram?

A sper­mio­gram is the fer­ti­lity test for men. Th­rough a de­tailed ex­ami­na­tion of the male eja­cu­late in the la­bo­ra­tory, the sperm qua­lity and the man’s ability to con­ceive can be che­cked.

Ex­cept in cases of un­wanted child­less­ness, a sper­mio­gram is also car­ried out after a vasec­tomy (ste­ri­li­sa­tion of the man). This can be used to de­ter­mine whe­ther there are re­ally no more sperm in the eja­cu­late and whe­ther the pro­ce­dure was the­r­e­fore suc­cessful.

The pro­ce­dure for a sper­mio­gram is pain­less and wi­t­hout any side ef­fects. The only thing the man has to do is give his sperm to the la­bo­ra­tory. The sub­se­quent ana­lysis will de­ter­mine whe­ther [1]:

  • there are too few sperm in the eja­cu­late (oli­go­zoo­spermia)
  • the sperm are too im­mo­bile (asthe­no­zoo­spermia)
  • there is a mal­for­ma­tion of the sperm (tera­to­zoo­spermia).

In ad­di­tion, the fol­lo­wing cri­teria of the eja­cu­late are eva­luated:

  • ph-value
  • Cha­rac­te­ristics such as odour and co­lour
  • Sperm an­ti­bo­dies (MAR test)
  • Bac­te­rial co­lo­ni­sa­tion
  • Sugar con­tent
  • Vis­co­sity

Sper­mio­gram: Costs

The costs of a sper­mio­gram are usually bet­ween 60 and 90 euros [2]. For cou­ples who have not been able to con­ceive a child de­spite un­pro­tected se­xual in­ter­course over a longer pe­riod of time, the costs of the sper­mio­gram are co­vered by the he­alth insu­rance. If you want to be on the safe side ho­wever, it is ad­vi­sable to ob­tain written con­fir­ma­tion from the he­alth insu­rance fund be­fore the pro­ce­dure.
More in­for­ma­tion on fi­nan­cial sup­port for wan­ting a child.

Sper­mio­gram: Pro­ce­dure

In order to get a meaningful test re­sult, it is re­com­mended that you ab­s­tain from sex and mas­tur­ba­tion for about four to five days be­fore the pro­ce­dure. Ho­wever, abs­ti­nence should not last longer than seven days, be­cause even though this in­creases the number of sperm in the eja­cu­late, their moti­lity de­te­rio­rates after this pe­riod.

On the day of the sper­mio­gram, a semen sample must be given by means of mas­tur­ba­tion. It is im­portant to strictly follow all the doc­tor’s in­s­truc­tions, to wash the hands and penis tho­roughly be­fore mas­tur­ba­tion and to use a ste­rile con­tainer for eja­cu­la­tion. At the time of de­li­very, the sample must be very fresh and no more than half an hour old [3].

As soon as the semen sample has been de­li­vered to the la­bo­ra­tory, the ac­tual ex­ami­na­tion be­gins.  First, the li­quefac­tion and vo­lume of the eja­cu­late are tested [4]. If they do not cor­re­spond to the norm, these can be the first signs that the man is unable to con­ceive.

Then the ana­lysis be­gins under the mi­cro­scope, du­ring which the number, mo­bi­lity, shape and other pa­ra­me­ters are tested. The de­ter­mi­na­tion of the re­sult can take bet­ween one and seven days, de­pen­ding on the la­bo­ra­tory.

But don’t panic if the re­sult is ne­ga­tive the first time: since the qua­lity of the sperm va­ries weekly and even reveals the man’s state of he­alth on the day of the ex­ami­na­tion, the test can be re­peated with fresh sperm around eight to twelve weeks later [5].

Sper­mio­gram: Eva­lua­tion

The eva­lua­tion of the sper­mio­gram shows whe­ther the pa­tient is fully, par­ti­ally or not at all fer­tile. The re­sult thus pro­vides some cla­rity for the cou­ple’s si­tua­tion. For the pro­fes­sional per­for­mance of a com­pe­tent semen ana­lysis, the World He­alth Or­ga­ni­sa­tion (WHO) pu­blished gui­de­lines on the “Eva­lua­tion of Fer­ti­li­sable Sperm” in 2010 [5]. In this way, a glo­bally valid stan­dard can be en­sured. The fol­lo­wing table lists the ge­neral stan­dard va­lues of a sper­mio­gram that are used for eva­lua­tion [5]:

Normal va­lues of a sper­mio­gram:

Vo­lume in ml: at least 1.5ml

Total number of sperm: at least 39 mil­lion

Pro­por­tion of li­ving sperm: at least 58

Sperm per ml: at least 15 mil­lion

pH value: bet­ween 7 and 8

Pro­por­tion of well-motile sperm: at least 32%.

Pro­por­tion with normal shape: at least 4%

White blood cell count: less than 1 mil­lion per ml

Li­quefac­tion time: bet­ween 30 and 60 mi­nutes

MAR test: below 50% sperm an­ti­bo­dies

If the sper­mio­gram re­sults are ne­ga­tive even after re­peated at­tempts, fur­ther tests are in order. Among other things, an ul­tra­sound ex­ami­na­tion of the man’s testicles and pro­state, as well as a blood or hor­mone test could be useful. There are many dia­gnoses that are found as a re­sult of a sper­mio­gram eva­lua­tion. These in­clude:

  • Oligo-Astheno-Tera­to­zoo­spermia Syn­drome (OAT syn­drome) — A pa­tho­lo­gical ch­ange in semen qua­lity. This oc­curs when there are too few, too im­mo­bile and mal­formed sperm in the eja­cu­late at the same time.
  • Azoo­spermia — No sperm at all can be found in the eja­cu­late.
  • Aspermia — This oc­curs when no eja­cu­late could be ob­tained.
  • Par­ve­semia — The vo­lume of the eja­cu­late is below the WHO stan­dard (min. 1.5 ml).

What can you do to im­prove sperm qua­lity?

And now for the good news: Un­like women, who are born with a li­mited number of eggs, men are al­ways forming new sperm. So the sper­mio­gram is more or less a snapshot. And this can be po­si­tively in­fluenced!

As is so often the case, a ch­ange in life­style can be a great help. This in­cludes a he­althy and ba­lanced diet and suf­fi­cient vit­amin in­take (zinc, vit­amin C, se­le­nium). In ad­di­tion, sport and exer­cise are very im­portant be­cause they in­crease tes­to­ste­rone le­vels, which are es­sen­tial for sperm pro­duc­tion. In con­trast, men who are over­weight have been found to be de­fi­cient in tes­to­ste­rone, which can cause sperm qua­lity to suffer si­gni­fi­cantly [6].

It is also ad­vised to ab­s­tain from or at least re­duce the con­sump­tion of the usual cul­prits such as al­cohol, ni­co­tine and ana­bolic ste­roids [7].

Heated seats in the car, too tight pants and other fac­tors that can lead to over­hea­ting of the semen should be avo­ided as far as pos­sible. It is not for not­hing that the testicles are lo­cated out­side the body, as the body tem­pe­ra­ture would be too warm for them. So na­ture has once again thought of ever­y­thing!

Other fac­tors are stress, and the “pres­sure to pro­create” that often ac­com­pa­nies cou­ples with an unful­filled child wish. Even if it is not al­ways easy, one should try to mi­ni­mize stress and un­pro­duc­tive worries. They help no one and can only lead to fur­ther pro­blems.

To learn more about the con­nec­tion bet­ween fer­ti­lity and psy­cho­lo­gical fac­tors, click here!

No one can gua­rantee that these me­a­sures will work in every single case, but they are de­fi­ni­tely worth a try. And even if they don’t al­ways help you to ful­fill your de­sire to have children, you are doing your he­alth and yourself a favor in any case.

Test the qua­lity of your sperm

The At-home sperm test

At-Home Spermientest - Fertilly

Take your fer­ti­lity into your own hands!

Im­pro­ving your sperm he­alth in­creases your chances of con­cep­tion. With the At-Home Sperm Test, you can ea­sily check your sperm qua­lity from the com­fort of your own home. Using ad­vanced fer­ti­lity tech­no­logy, you’ll re­ceive ac­cu­rate in­for­ma­tion about the vo­lume, con­cen­tra­tion and mo­bi­lity of your sperm on your smart­phone in only 15 mi­nutes. The app also pro­vides you with va­luable per­so­na­lised tips to im­prove your sperm he­alth.

Learn more

About Fer­tilly

At Fer­tilly, we have made it our mis­sion to ac­com­pany cou­ples (ho­mo­se­xual and he­te­ro­se­xual) and sin­gles on the way to ful­fil­ling their child wish. In doing so, it is im­portant to us to create trans­pa­rency in the area of fer­ti­lity ser­vices, to pro­vide in­for­ma­tion and know­ledge on the to­pics of pregnancy and fer­ti­lity and to help you to find the most sui­table Fer­ti­lity Center. Th­rough co­ope­ra­tion with first-class Fer­ti­lity Cen­tres and cli­nics in Eu­rope, en­qui­ries about Fer­tilly are given pre­fe­ren­tial tre­at­ment. This means that our pa­ti­ents avoid the usually long wai­ting times and get ap­point­ments more quickly.

If you would like more in­for­ma­tion about Fer­ti­lity Cen­ters, suc­cess rates and prices, please contact us using this ques­ti­on­n­aire. We will ad­vise you free of charge and wi­t­hout any ob­li­ga­tion.

  • Answer the first ques­tions in the on­line form in order to book an ap­point­ment. This way we can better ad­dress your needs du­ring the con­ver­sa­tion.

  • We will find the best contact person for your in­di­vi­dual needs. Sche­dule 20 mi­nutes for the con­sul­ta­tion.

  • We will in­tro­duce you to the right fer­ti­lity clinic from our net­work, make an ap­point­ment and ac­com­pany you until your wish for a child is ful­filled.

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1. Doc­Check Fle­xikon, 2017. Sper­mio­gramm — https://flexikon.doccheck.com/de/Spermiogramm#Untersuchte_Merkmale
2. Hermes, S., o.D. Sper­mio­gramm: Wie fit sind deine Sa­men­zellen? ‑https://www.eltern.de/kinderwunsch/fruchtbarkeit/spermiogramm-kosten-auswertung%20#section_46627 (Zu­griff am 10.07.2019)
3. Breit­bach, E., 2019 — https://www.wunschkinder.net/theorie/diagnostik-der-sterilitaet/diagnostik-beim-mann/#untersuchung-des-ejakulats-spermiogramm
‍4. Manski, D., 2019. Sper­mio­gramm (Eja­ku­lat­ana­lyse): Durch­füh­rung und Aus­wer­tung. — https://www.urologielehrbuch.de/spermiogramm.html
5. Bun­des­zen­trale für ge­sund­heit­liche Auf­klä­rung, 2017. Der Sa­men­test: Bin ich fruchtbar? ‑https://www.familienplanung.de/kinderwunsch/diagnostik/untersuchungen-mann/der-samentest/
6. Wu, F., et al. (2008, Jul). Hy­po­tha­lamic-pi­tui­tary-testi­cular axis dis­rup­tions in older men are dif­fe­ren­ti­ally linked to age and mo­di­fiable risk fac­tors: the Eu­ro­pean Male Aging Study. J Clin En­do­crinol Metab , 93 (7), pp. 2737–45.
7. Win­ter­mantel, B., o.D. — https://www.eltern.de/kinderwunsch/fruchtbarkeit/kinderwunsch-was-kann-er-tun.html