A semen analysis measures six things: volume, concentration, total sperm count, progressive motility, normal morphology and vitality. Together they show how many sperm there are, whether they can move well enough to reach the egg, whether they have the proper shape and how many are alive. It is the most important and most ignored test in the process.
In up to 30% of cases of difficulty conceiving, the factor is exclusively male. In another 20%, it's combined. That means half the equation is on him, and most couples ignore that until it's too late. Ignoring it is throwing up to 30% of the chances in the trash.
Results come back in 1 to 2 days. Before you keep spending time and energy trying, he needs to get a semen analysis. In the book's 90-day plan, ordering it is one of the actions of the very first month. It sits on his list of preconception tests together with complete serologies, glucose and blood count, and total testosterone (especially if he is 35 or older or has signs of low levels).
| Parameter | What it indicates |
|---|---|
| Volume | Prostate and seminal vesicles |
| Concentration | Total amount (sperm per mL) |
| Total sperm count | Absolute total in the ejaculation |
| Progressive motility | Ability to reach the egg |
| Normal morphology | Proper shape |
| Vitality | How many are alive |
Parameters as listed in the WHO reference (2021).
Read the table in two halves. The first three rows are about quantity: how much semen, how many sperm per mL and how many in total. The last three are about quality: whether they move forward, whether they have the proper shape and whether they are alive.
Why look at so many angles? In a single ejaculation there are between 40 and 300 million sperm. Of those, only a few hundred reach the correct tube, and only one fertilizes the egg. It's a brutally selective process, so both quantity and quality count.
Each parameter has a WHO 2021 reference value; the numbers, and what to do with a result below them, are on the normal values page.
A badly prepared sample can give a misleading result. The book's checklist:
Sperm production varies naturally. An unexpected result is repeated after 4 to 12 weeks before drawing conclusions.
The semen analysis is part of Chapter 25 of Map to the Positive, "His fertility: what he needs to do", in Station III (Optimization). The chapter also gives the WHO reference values, the 10 habits with a measurable effect on sperm in 90 days, and the signs that call for a urologist. The rest of Station III covers nutrition, supplements for both of you, sleep, stress, exercise and sex at the right time.
Take 30 days. If it does not give you more clarity than everything you have read for free so far, ask for a refund and you get every cent back. We cannot promise you a pregnancy. We can promise you will not be guessing.
References: WHO laboratory manual for the examination and processing of human semen, 6th ed., 2021.