What it is (overview)

A Semen Analysis (Complete Semanogram)—also called a spermiogram—is a laboratory fertility test that evaluates semen and sperm health. It is one of the most common first-line tests used to assess male fertility.

In plain language, this test looks at whether sperm are present in adequate numbers, whether they move well enough to reach and fertilize an egg, and whether they have a typical shape that supports fertilization. A complete semen analysis typically measures:

• Semen volume: The amount of semen in the sample. Low volume can suggest issues with the seminal vesicles, prostate, ejaculatory ducts, hydration, or collection method.

• Sperm concentration (sperm count): How many sperm are present per milliliter and in the entire ejaculate. A low sperm count (oligozoospermia) may reduce the chance of pregnancy; no sperm (azoospermia) suggests a production problem or blockage.

• Motility: The percentage of sperm that move, and how well they move (progressive movement is most important). Poor motility (asthenozoospermia) can make it difficult for sperm to travel through the female reproductive tract.

• Morphology: The percentage of sperm with a normal shape (head, midpiece, tail). Abnormal morphology (teratozoospermia) may be associated with reduced fertility, although many factors influence conception.

• Vitality: Whether non-moving sperm are alive or dead; helpful when motility is low.

• Liquefaction time & viscosity: How the semen changes from gel-like to liquid and how thick it is; abnormal results can interfere with sperm movement.

• pH and appearance: Can provide clues about infections or problems with accessory glands.

• White blood cells (leukocytes): Elevated levels may suggest inflammation or infection (leukocytospermia).

Because semen parameters naturally vary, clinicians often interpret results alongside your history and may recommend repeating the semen analysis (commonly 2 tests, several weeks apart) to confirm a pattern. “Normal” results generally mean the measured sperm parameters fall within expected reference ranges; “abnormal” results point to potential causes of subfertility and help guide next steps (lifestyle changes, treatment of infection, hormonal testing, ultrasound, or referral to a fertility specialist).

When & why it's usually done

A complete semanogram is usually ordered when a couple has difficulty conceiving or when there are concerns about male reproductive health. Common reasons include:

• Trouble getting pregnant: Often recommended after 6–12 months of trying to conceive (sooner if the female partner is older or if there are known risk factors).

• Known or suspected male factor infertility: Such as a history of low sperm count, prior abnormal semen testing, or symptoms suggesting a reproductive issue.

• Varicocele or scrotal concerns: A varicocele (enlarged veins in the scrotum) can affect sperm production and quality.

• Hormonal concerns: Low libido, erectile dysfunction, reduced body hair, or other signs that may point to low testosterone or pituitary/testicular hormone issues.

• Past infections or inflammation: Prior sexually transmitted infections (STIs), epididymitis, prostatitis, or mumps orchitis can impact sperm health.

• Prior surgery or injury: Vasectomy reversal evaluation, hernia surgery, testicular trauma, or pelvic surgery that may affect sperm transport.

• Exposure risks: Heat exposure (frequent hot tubs/saunas), radiation, certain chemicals/pesticides, heavy alcohol use, smoking/vaping, cannabis use, anabolic steroids/testosterone therapy, or certain medications that can reduce sperm production.

• After cancer treatment: To assess fertility following chemotherapy or radiation, or when planning sperm banking.

• Post-procedure follow-up: To confirm sterility after vasectomy (post-vasectomy semen testing) or to monitor improvement after treatment (e.g., varicocele repair or medical therapy).

Preparation instructions can affect accuracy. Many labs recommend 2–7 days of abstinence before collection, collecting the full sample, and delivering it promptly under proper temperature conditions. Your clinician or lab will provide the exact instructions.

Common diseases related to it

• Male factor infertility (subfertility)
• Oligozoospermia (low sperm count)
• Azoospermia (no sperm in ejaculate)
• Asthenozoospermia (reduced sperm motility)
• Teratozoospermia (abnormal sperm morphology)
• Varicocele
• Obstructive disorders (e.g., ejaculatory duct obstruction, congenital absence of the vas deferens)
• Hypogonadism and other hormonal disorders affecting spermatogenesis
• Prostatitis, epididymitis, orchitis (including post-mumps orchitis)
• Leukocytospermia (semen inflammation/infection marker)

Health goals where it may help

• Evaluating and improving fertility when trying to conceive (TTC)
• Identifying potential causes of abnormal sperm count, motility, or morphology to guide treatment
• Monitoring response to lifestyle changes (weight management, smoking cessation, reducing heat/toxin exposure)
• Planning fertility preservation (e.g., sperm banking before chemotherapy or radiation)
• Confirming effectiveness of vasectomy (post-vasectomy semen analysis)
• Supporting decisions about assisted reproductive options (IUI, IVF, ICSI) based on spermiogram results