Interpretation of Your Semen Analysis Results
Your Results Indicate Reduced Fertility Potential Due to Low Progressive Motility
Your semen analysis shows normal sperm count (38 million/mL) and volume (4.5 mL), but your progressive motility of 20% falls significantly below the normal threshold of ≥30%, indicating asthenozoospermia (reduced sperm motility) which impairs fertility potential. 1
Understanding Your Specific Parameters
What's Normal vs. Abnormal in Your Results:
Normal findings:
- Sperm concentration: 38 million/mL exceeds the lower reference limit of 16 million/mL 1
- Total sperm count: 171 million exceeds the lower reference limit of 39 million per ejaculate 1
- Volume: 4.5 mL is within the normal range of 1.4-6.0 mL 1
Abnormal findings:
- Progressive motility (PR): 20% is below the normal threshold of ≥30% 1
- Total motility (PR + NP): 44% (20% + 24%) is borderline, just above the lower reference limit of 42% 1
- Immotile sperm: 56% is elevated, indicating more than half your sperm are not moving 1
What This Means for Your Fertility
Your fertility potential is reduced but not absent. Progressive motility is one of the most critical parameters for natural conception because sperm must actively swim through cervical mucus and reach the egg 2, 3. With only 20% progressive motility, your chances of natural conception are diminished compared to men with normal parameters 1.
Key clinical implications:
- Men with progressive motility ≥30% have significantly better pregnancy rates with intrauterine insemination (IUI), averaging 8-11% per cycle 2
- When progressive motility falls below 30%, as in your case, natural conception becomes more challenging and assisted reproductive techniques may be needed 2
- Your total motile sperm count (concentration × volume × progressive motility = 38 × 4.5 × 0.20 = 34.2 million) is above the threshold of 5 million needed for IUI success 2
Important Considerations About Your 4-Day Abstinence Period
Your 4-day abstinence period is appropriate and within the recommended 2-7 day window for semen analysis. 1 However, research shows that in men with reduced motility (asthenozoospermia), more frequent ejaculation may actually improve fertility outcomes 4:
- In oligoasthenospermic men, sequential ejaculation 1-4 hours apart increased total motile sperm counts by 233% 4
- Daily or twice-daily intercourse during ovulation may increase fertility potential in men with impaired motility 4
Essential Next Steps and Diagnostic Workup
You must repeat the semen analysis in at least one month to confirm these findings, as significant intra-individual variability exists between samples. 1 A single abnormal result is not diagnostic 5.
Required hormonal evaluation:
- Measure serum FSH, LH, and total testosterone to distinguish primary testicular dysfunction from secondary causes 6
- Elevated FSH suggests impaired spermatogenesis, while normal FSH with low motility may indicate other causes 6
Consider genetic testing if repeat analysis confirms abnormalities:
- Karyotype testing is recommended if sperm concentration drops below 5 million/mL on repeat testing 6, 5
- Y-chromosome microdeletion testing should be considered for severe oligospermia 5
Modifiable Factors That May Be Reducing Your Motility
Lifestyle and environmental factors significantly impact sperm motility and should be addressed immediately: 1, 5
- Stress reduces progressive motility 1, 5
- Anabolic steroid use severely impairs fertility and motility 1, 5
- Poor diet reduces fertility even in young men 5
- Chemical exposures (e.g., phthalates) lower sperm quality 5
- Smoking and excessive alcohol consumption (>10g per week) decrease sperm parameters 7
Treatment Options and Prognosis
If repeat analysis confirms persistent low progressive motility, assisted reproductive techniques offer good success rates:
- Intrauterine insemination (IUI) is effective when progressive motility is ≥30% and total motile sperm count is ≥5 million 2
- Your total motile sperm count of 34.2 million exceeds this threshold, making IUI a viable option if natural conception fails 2
- In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) may be considered if IUI fails or if motility worsens 6
Critical Caveats and Pitfalls to Avoid
Do not assume this single test defines your fertility status. 1, 5 Semen parameters vary significantly between samples, and at least two analyses separated by one month are required for accurate assessment 1.
Ensure proper collection technique for repeat testing:
- 2-3 days of sexual abstinence before collection 1
- Transport at body temperature if collected at home 1
- Examination within one hour of collection 1
Watch for these red flags requiring urgent urology referral: