Sperm count is the total number of sperm in a particular quantity of semen, the fluid that carries sperm out of the penis. Sperm concentration refers to how densely packed those sperm are within the semen. For example, a sample may include 3 milliliters of semen (volume) and a total sperm count of 45 million; that would be a concentration of 15 million sperm per mL.

Motility refers to the ability of the sperm to move or “swim,” which is essential for them to move through the female reproductive system and fertilize the egg. Progressive motility is the best type of movement that can be seen in sperm testing—that means the sperm move forward in straight lines or in large circles, as opposed to in small tight circles or along erratic paths.

Morphology means the sperm’s structure or shape, which is ideally:

• a smooth oval head
• a well-defined acrosome, or cap, that covers 40–70% of the head
• a long tail with no visible abnormalities

This shape is important because it impacts a sperm’s ability to travel to and penetrate an egg.

Sperm testing is often done:

• If you are trying to conceive. If you and your partner have been having unprotected sex for 6–12 months and haven’t yet gotten pregnant, semen analysis is a first-line test to help diagnosis or rule out male fertility issues. Doing sperm testing early on in the process of trying to conceive can help you avoid costly and unnecessary tests or treatments down the line.
• To proactively improve fertility. Even if you’re not trying to conceive right now, you may want to proactively assess—and address—sperm health issues. Because sperm take about 74 days to produce, it will take at least 2–3 months for any lifestyle changes you make to have a measurable impact on your sperm health. Sperm testing in advance can help ensure that, by the time you’re ready to start a family, your sperm is in its best possible shape.
• If you plan to freeze your sperm. If you’re freezing your sperm for the future—whether because you’re about to undergo cancer treatment or because you simply want to preserve your sperm at its youngest, healthiest state—sperm testing is crucial. You’ll want to ensure your sperm is healthy and fertile before freezing.
• To assess the results of a vasectomy or vasectomy reversal. If you have a vasectomy for long-term birth control, it’s recommended that you get a semen analysis around 12 weeks after the procedure, to confirm the vasectomy has worked as intended. Similarly, if you have surgery to reverse a previous vasectomy, sperm testing every month for 12 months is recommended to ensure sperm quality, count, and motility is recovering normally.

Learn more about why semen testing is important.

How is a sperm test done? And which is the best sperm count test for you—in-office, or at-home?

Traditionally, a semen analysis happens at a fertility clinic or urologist’s office with an andrology lab (a lab specifically set up for sperm testing, processing, and freezing). In this context, the office will usually require a prescription or referral from your doctor.

The semen sample for sperm testing is typically collected in a small cup via masturbation, either there in the office (in a “collection room”) or at home, and brought to the lab within 60 minutes. From there, the lab staff will examine the sample under a microscope to evaluate the sperm count, morphology, and motility, and results will be prepared and available in a few days. 

With at-home sperm analysis, such as what’s offered here at Legacy, you are able to collect your sample in the comfort of your home. The Legacy sperm testing kit includes a special buffering medium that keeps your sample viable for up to 48 hours, as opposed to the usual 60 minutes. The sample is shipped overnight to the lab, where a technician will analyze it.

Many mail-in sperm testing kits give only the basic results, like sperm count and concentration. Legacy’s analysis kit tests for every sperm parameter evaluated in an andrology lab, and offers personalized recommendations for improving sperm health based on your lifestyle and sperm testing results.

A typical cost for an in-office semen analysis is about $250, but it requires a prescription from a doctor, and the office visit may have a separate fee. The cost of a Legacy at-home semen analysis is $195, and it does not require a prescription from a doctor.

Abnormal sperm can come in a multitude of forms. In more comprehensive reports, you may see a breakdown of the types of abnormal sperm your sample contains. Some examples include:

• Abnormalities in the sperm head size or shape, including amorphous, pyriform, vacuolated, tapering, or large heads.
• Defects in the sperm midpiece or “neck,” including a bent or asymmetrical neck.
• Defects or absence of the acrosome, the cap that covers the sperm head and helps the sperm penetrate the egg.
• Abnormalities in the sperm tail, such as a coiled tail.
• Multiple heads or tails, or the absence of heads or tails.
• The presence of droplets of excess residual cytoplasm, or cell material that once held immature sperm together but should have been removed during the maturation process.

Poor sperm morphology, as evidenced by a low percentage of normal sperm, is known as teratozoospermia. It’s important to note that a very low percentage of normal sperm—or even no normally shaped sperm at all—does not necessarily mean you are infertile. In fact, in one study, nearly 30% of men with 0% normal morphology were still able to achieve pregnancy with their partner without fertility treatment, as compared to 55% of men with healthy morphology results. Morphology is just one of many factors that contribute to the overall understanding of male fertility.

Legacy’s sperm testing report includes a unique benefit—guidance on how to improve your sperm health, based on questions you’ve answered about your lifestyle (for example, how often you exercise, your diet, and the type of underwear you wear). These recommendations can help you understand how your lifestyle choices impact your sperm health and sperm testing results, and how to make changes that will result in healthier sperm and higher fertility.