Understand results
Semen analysis results explained
How to read semen volume, concentration, total count, motility, morphology and vitality without treating the reference limits as a diagnosis.
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Short answer
Read each line against the reference limit printed for that measurement, then read the lines together. NICE uses WHO lower limits: volume 1.4 ml, concentration 16 million/ml, total sperm number 39 million, total motility 42%, progressive motility 30%, vitality 54% and normal morphology 4%. A line below a limit is “below the current reference value”. It is not a fertility verdict.
Key takeaways
- Concentration and total sperm number answer different questions.
- Total motility and progressive motility are not interchangeable.
- 4% normal forms often surprises people. It is a lower limit, not a mark out of 100.
- pH of 7.2 or more is part of the NICE/WHO comparison. This site’s decoder does not score pH.
| Measurement | Reference value | How to read it |
|---|---|---|
| Semen volume | 1.4 ml or more | Within the current reference range at or above this value |
| Sperm concentration | 16 million/ml or more | Within the current reference range at or above this value |
| Total sperm number | 39 million or more | Within the current reference range at or above this value |
| Total motility | 42 % or more | Within the current reference range at or above this value |
| Progressive motility | 30 % or more | Within the current reference range at or above this value |
| Vitality | 54 % or more | Within the current reference range at or above this value |
| Normal morphology | 4 % or more | Within the current reference range at or above this value |
NICE also cites semen pH of 7.2 or more. These are lower reference limits, not a fertility diagnosis.
Semen volume
Volume is the amount of semen, in millilitres. The lower reference limit is 1.4 ml. A low volume can reflect a short abstinence period, an incomplete sample, or a problem with the glands that make seminal fluid. It can also be a collection issue: if part of the ejaculate missed the pot, the first portion is especially important because it is sperm-rich. Tell the laboratory if any was lost.
Concentration and total sperm number
Sperm concentration is sperm per millilitre. Total sperm number is sperm in the whole sample. A high volume can hide a modest concentration, and a small volume can make a reasonable concentration look like a low total. If both figures are on your report, they should roughly agree with volume × concentration. Laboratories round, so a small difference is expected.
Motility
Total motility counts every moving sperm. Progressive motility counts sperm that move forward. Progressive motility cannot be higher than total motility. If your report shows that, ask the laboratory which figure is which before you compare them with 42% and 30%.
Motility falls as a sample sits. A result from a sample examined many hours after production is not comparable with a sample examined within the hour.
Morphology
Morphology is the percentage of sperm with a normal shape under strict criteria. The lower reference limit is 4%. In the reference population, most sperm are not classed as normal. A report of 5% or 6% is within the current reference range. It is not a poor mark on a school scale.
Vitality
Vitality is the percentage alive. The lower reference limit is 54%. It helps when motility is low: if many sperm are alive but not moving, that is a different finding from many sperm being dead.
Reading the report as a whole
Clinicians do not treat each percentage as a separate diagnosis. A borderline concentration with strong progressive motility is not the same situation as azoospermia. NICE recommends a physical examination of the scrotum and testes after two or more abnormal analyses, and hormone tests may be used to look for a treatable endocrine cause. Those steps are clinical care, not something a calculator can finish.
Questions
What does “below the reference value” mean?
That measurement is under the lower limit NICE cites from WHO. It is a reason for clinical follow-up, often including a repeat test. It is not a statement that you cannot conceive.
Why is normal morphology only 4%?
Because the limit is a 5th-centile value from a fertile reference group assessed with strict shape criteria. It was never a target of 100% normal sperm.
Related
Sources
- WHO laboratory manual for the examination and processing of human semen, 6th edition — World Health Organization, 2021
- Fertility problems: assessment and treatment (NG257) — NICE, 2026
- NG257: investigation of fertility problems and management strategies — NICE, 2026
- Low sperm count — NHS
How this page was prepared
Drafted with automated research assistance and checked against the cited primary sources. A named clinician has not reviewed this page. Medical review is pending. Changes to reference values are not published automatically.