Table 2

Semen analysis reference values (WHO criteria)57

Normal valueDescription of abnormalityFurther specialist tests to be considered if abnormal
Semen volume≥1.5 mLOligospermiaConsider obstructive causes/CBAVD-CFTR mutation
Aspermia (no ejaculate)—assess prostate and for retrograde ejaculation with post-ejaculatory urine analysis
Sperm concentration≥15 million spermatozoa per mLOligozoospermia <15 million
Severe oligozoospermia <5 million
Azoospermia (no sperm)
If <10 million:
Endocrine evaluation
(FSH / LH / 10 am fasting testosterone) / clinical examination /US Doppler for varicocele
If <5 million:
Chromosomal analysis/PCR for Y microdeletions
Total motility≥40% motileAsthenozoospermiaAnti-sperm antibody
Sperm viability and membrane test
Vitality≥58% live spermatozoa
Morphology≥4% normal formsTeratozoospermiaSperm penetration assay
  • CBAVD, congenital bilateral absence of the vas deferens; CFTR, cystic fibrosis transmembrane conductance regulator; FSH, follicle stimulating hormone; LH, luteinising hormone; US, ultrasound.