Is a semen analysis showing a volume of 1.6 mL, sperm concentration of 106 million/mL, and progressive motility of 29 % (total motility 38 %) normal in a 28‑year‑old male?

This semen analysis is NOT entirely normal and warrants repeat testing and further evaluation.

Your results show borderline-to-abnormal progressive motility (29%) that falls below the WHO reference limit of ≥30-32%, despite having excellent sperm concentration and adequate volume. 1

Key Findings Analysis

Parameters Meeting Reference Standards:

• Volume: 1.6 mL (reference ≥1.4-1.5 mL) ✓
• Sperm concentration: 106.3 million/mL (reference ≥15-16 million/mL) ✓✓ — This is excellent, well above normal

Parameters Below Reference Standards:

• Progressive motility: 29% (reference ≥30-32%) ✗ — This is asthenozoospermia (reduced sperm motility)
• Total motility: 38% (PR 29% + NP 9%) is borderline, just below the ≥40-42% threshold 1

Clinical Significance

The 2024 AUA/ASRM guidelines explicitly state that semen parameters are highly variable biological measures and may fluctuate substantially from test to test. Therefore, at least 2 semen analyses obtained a month apart are important to consider, especially if the first SA has abnormal parameters. 1 Your reduced progressive motility qualifies as an abnormal parameter requiring confirmation.

Important caveat: The most recent 2025 EAU guidelines emphasize that semen analysis alone cannot be used to distinguish fertile from infertile men 2. Many men with parameters slightly below reference values still achieve natural pregnancy, while some with "normal" parameters may have fertility challenges.

Recommended Next Steps

1. Repeat semen analysis in 1 month with 2-5 days abstinence (ideally 4-5 days for optimal comparison) 3

2. During the waiting period, address modifiable factors that affect sperm motility:

   • Avoid excessive heat exposure (hot tubs, saunas, tight underwear)
   • Optimize lifestyle: smoking cessation, limit alcohol (>10g/week reduces sperm parameters) 4
   • Maintain healthy BMI (both obesity and underweight affect parameters) 4
   • Consider antioxidant supplementation, though high-quality evidence is limited 2

3. If repeat analysis confirms low motility, proceed with:

   • Medical and reproductive history
   • Physical examination (testicular size, varicocele assessment)
   • Hormonal evaluation (FSH, testosterone) 2
   • Consider oxidative stress as a cause (though routine ROS testing is not currently recommended) 2

Fertility Prognosis Context

Research shows that higher semen parameters well above WHO minimums are associated with better conception rates and shorter time-to-pregnancy 5. Your excellent sperm concentration (106 million/mL) is highly favorable. However, the reduced progressive motility may impact natural conception rates, particularly the total progressive motile count (TPMC), which is calculated as: volume × concentration × progressive motility percentage.

Your TPMC = 1.6 mL × 106.3 million/mL × 0.29 = approximately 49 million — just below the 50 million threshold associated with optimal natural conception rates in subfertile couples 5.

Bottom line: While not severely abnormal, your results indicate mild asthenozoospermia requiring confirmation with repeat testing and potential further workup if persistent. The excellent sperm count is reassuring, but the motility issue should not be dismissed.