How to prepare for a semen analysis

Abstinence

The gap since the last ejaculation changes concentration and volume. Very short gaps can lower the count. Very long gaps can increase the proportion of older, less motile sperm. The usual WHO-aligned window is 2 to 7 days. Some NHS andrology services ask for a point inside that window. Read the abstinence page and then use the interval your appointment letter specifies.

Collecting the sample

Laboratories generally want the whole ejaculate, produced by masturbation, in a toxicity-tested container they provide. A container from home, or one given for a urine sample, can harm sperm. If you produce the sample at home, the laboratory will tell you how quickly it must arrive and whether they accept home production at all. Many services prefer an on-site room so the sample is not cooled or delayed.

• Do not use lubricant, condom collection or saliva unless the laboratory has given you a tested alternative.
• If any semen is spilled, say so, and say whether it was the first or last part.
• Keep the pot warm, close to body temperature, not in a fridge and not on a radiator.
• Label it as the laboratory asks. An unlabelled pot may be rejected.

Illness, medicines and heat

A fever in the previous few months can affect a sample because sperm were developing during that illness. Say so on the form. Do not stop a prescribed medicine, including testosterone, in order to “improve” a test. Tell the clinician what you take. Anabolic steroids and testosterone therapy can markedly suppress sperm production. That history belongs on the request, not in a last-minute change of medication.

After the result

You do not need to interpret the report alone. If it is abnormal, NICE’s usual pattern is a confirmatory test, sooner if sperm are absent or extremely low. The results guide explains the lines. The decoder can place optional figures against the reference limits without storing them.