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Male Fertility

In about a third of couples struggling with subfertility the main problem lies with the male. We also find that in up to half (50%) of couples with infertility issues , there is a problem with sperm.

This is usually because there are insufficient numbers of normal sperm available to fertilise the egg, or because of a problem with abnormally shaped sperm, sperm that doesn’t move well or a presence of antibodies. The laboratory assessment of the quality of semen is a vital factor in fertility.

The easiest way to identify a male factor problem is to do a “sperm test” otherwise known and semen analysis. Semen analysis should be undertaken in all couples seeking investigation for infertility regardless of whether there is an identified female problem or a suspected male factor problem. Even if the male partner has previously fathered children a semen analysis is necessary since problems may have developed in the intervening time.



We offer a Detailed sperm analysis carried out in our accredited laboratory with a patient friendly report written by our expert Andrology team.

What is a Detailed Semen Analysis?

The test involves the microscopic examination of semen to assess the concentration, motility and the morphology of the sperm against the 2010 World Health Organisation reference values.  In addition to this we also look for the presence of anti-sperm antibodies which may affect mobility of the sperm.

Sperm Concentration: This is also known as ‘sperm count’ and is a measure of how many million sperm are present in each mL of your semen sample.  The World Health Organisation suggests that a normal semen sample should contain at least 15 million sperm per mL.

Sperm Concentration: This is also known as ‘sperm count’ and is a measure of how many million sperm are present in each mL of your semen sample.  The World Health Organisation suggests that a normal semen sample should contain at least 15 million sperm per mL.

Total Count :This indicates the total number of sperm in your ejaculate calculated using the volume and the sperm concentration.  The World Health Organisation suggests that a normal semen sample should contain at least 39 million sperm.

Progressive Motility: This indicates the percentage of sperm in your sample which are swimming in a forward manner (progressively motile) and graded on their speed.  The world Health Organisation suggests that a normal semen sample should contain at least 32% progressively motile sperm.

Normal Forms: Also known as sperm morphology, this is a measure of the shape and size of the sperm in your sample and is reported as a ‘normal’ percentage.  The World Health Organisation suggests that a normal semen sample should contain at least 4% normal forms.

Anti-sperm Antibodies: These can occur when the body’s immune system launches an attack on your sperm. The antibodies may cause the sperm to stick together (agglutinate) or disrupt their ability to swim or impair their fertilising ability.  They are rare but commonly occur after a vasectomy reversal or severe groin injury or operation. Greater than 40% agglutination is considered significant.

How can I improve my sperm test result?

Unfortunately there is no simple answer to this question.  General lifestyle changes which may improve things include wearing loose fitting underwear, taking showers instead of long hot baths, not smoking and keeping alcohol intake to a minimum.  Some men do find that taking vitamin and mineral supplements help but if you have a healthy and varied diet this shouldn’t be necessary.

Why has the BCRM laboratory requested a repeat sample?

Although millions of sperm are produced by the testes everyday, for an entirely new batch of sperm to be ejaculated a complete cycle of spermatogenesis (sperm production) needs to occur.  This takes around 3 months.  By waiting this long between tests we can rule out any temporary disruptions to sperm production which may have been caused for example by a bout of illness or stress.

What happens if my results are sub-optimal or abnormal?  

We would suggest that you have a repeat sample to confirm or refute the original findings.  If this confirms that your sperm production or quality is sub-optimal or abnormal, it would be advisable to speak to a Fertility Specialist.


The Enhanced Semen Analysis includes everything offered in the Detailed Semen Analysis along with an additional test to measure your fertility potential. This additional test is known commercially as MiOXSYS and is used to measure oxidative stress. High levels of oxidative stress can affect your sperm’s ability to function normally and can cause DNA fragmentation. This can lead to delayed time to conception, suboptimal semen parameters and failed IVF outcomes.

Oxidative stress can happen when an imbalance occurs between the presence of oxidants (such as reactive oxygen species) and the body’s ability to detoxify them or repair the damage caused by them. MiOXSYS works by measuring this balance (known as the static oxidation-reduction potential).

If the test reveals an imbalance, your clinician should be able to guide you on ways to try and restore the balance. This may include further tests to check for infection or the presence of a varicocele or guidance on how to improve your lifestyle. It may be possible to treat oxidative stress with a course of antioxidants however it is important to discuss this with your clinician to avoid causing an imbalance the other way. Booking a retest after following making these changes will determine if an improvement has been made.

MiOXSYS may be useful for patients who have experienced recurrent pregnancy loss, have an increased paternal age, unexplained infertility, a history of genito-urinary tract infections, varicocele, lifestyle risk factors or a suboptimal semen analysis.

The test can be carried out on a single semen sample alongside the Detailed Semen Analysis. Results should be available in 2-3 days.


The Enhanced Plus Semen Analysis includes everything offered in the Enhanced Semen Analysis along with an additional test to assess DNA Fragmentation.

Although a semen analysis provides an idea of the amount of moving, normal looking sperm in your sample, a DNA Fragmentation test provides information about what is going on inside those sperm. A high level of DNA damage may lead to delayed time to conception, failed IVF outcomes and an increased risk of miscarriage.

The Exact tests, powered by SpermComet technology are performed offsite at the Examen Laboratory in Belfast. Your sample will be frozen and shipped using a special container to ensure your sperm remain at the correct temperature. Three report types are available so you can select  the one which best reflects your situation.

Exact Fertility – select this test if you are still at the early stages of your investigations.

Exact IVF – this may be useful if your sperm have been identified as suitable for IVF based on the results of a detailed semen analysis. Identification of high levels of DNA fragmentation may mean that ICSI could be a better treatment choice.

Exact Miscarriage – if you have a history of sporadic or recurrent miscarriage, this may be useful to identify if sperm DNA damage could be a contributing factor.

If the test reveals a high level of DNA fragmentation, your clinician should be able to guide you on what this means. If the Enhanced Plus Semen Analysis also revealed a high level of oxidative stress, it is possible that this may be a cause of the DNA damage. Your clinician may want to undertake further tests to check for infection or the presence of a varicocele. They may also discuss how you can make lifestyle changes which may improve your results. If you have already decided to embark on fertility treatment, the results may also help to decide whether IVF or ICSI is right for you.

The test can usually be carried out on a single sample alongside the Detailed Semen Analysis and MiOXSYS. Although results for most of the tests should be available in 2-3 days, results for the DNA Fragmentation test can take around 3 weeks.


We appreciate that seeking sperm analysis and being asked to produce a semen sample to order for the purpose of investigation may be difficult and embarrassing. Please be reassured that the laboratory team are vastly experienced and will answer any questions you have and provide guidance with professionalism and sensitivity.

Please ring: 0117 259 1159 or email: lab@BCRM.clinic to discuss the available tests, to make a booking and to arrange a convenient date and time for the sample to be received.

Samples can also be produced on site in one of our 3 dedicated rooms for these purposes.


Instructions for Production of the Semen Sample: 

In order to assess sperm at maximum quality please do not have sexual intercourse or masturbate for 2 days, but no more than 5 days before producing the sample. The sperm sample should be produced by masturbation into a special container (provided).

Please carefully note the following:

  • Most of the sperm in an ejaculate is in the first portion, therefore if you collect the sample by interrupting intercourse, it is likely that this will be lost, and we will diagnose a problem, which does not exist.
  • Please do not produce samples into condoms for analysis, as these contain spermicides that destroy sperm.
  • Should some of the ejaculate fail to enter the container please do not submit that sample for analysis.
  • We would recommend that you wash yourself with soap and water.

If your sample is produced off site, it is important that semen samples are analysed quickly after production, as sperm begin to die quite rapidly outside the body. Deliver your sample as quickly as possible, at most within an hour of production.

Keep the sample warm by carrying it upright in an inside pocket, but not keeping it too hot. Please label the container CLEARLY with your name and date of birth, and the date and time the sample was produced.

Semen Analysis Test Packages

Test: type of semen analysis What’s included Why/ when useful Cost £
Detailed Assessment of semen volume, sperm motility, sperm concentration, total sperm count and sperm morphology – compared to WHO 5th centile reference ranges.

Check for anti-sperm antibodies

Laboratory comment as to suitability for IVF/ ICSI (if applicable)

For anyone experiencing failure to conceive.
For patients who have had cytotoxic treatment.
To give an indication as to the likelihood of achieving a natural conception or to decide the most appropriate ART choice.
Enhanced Detailed + MiOXSYS – assessment of sORP (static oxidation reduction potential) which gives a measure of oxidative stress.
Result is in the form of a single value – see flow chart.
• recurrent pregnancy loss
• increased paternal age
• unexplained infertility
• history of genito-urinary tract infections
• varicocele
• lifestyle risk factors
• idiopathic suboptimal SFA
Action: results to be discussed with specialist doctor Antibiotics/antioxidants/varicocelectomy/
lifestyle changes. Review in 3 months.
Enhanced Plus Detailed, MiOXSYS and DNA Fragmentation Test • history of miscarriage
• >1 year TTC
• unsuccessful ART outcome
• normozoospermic men about to embark
• on IVF (could switch to ICSI if result is high.)
Action: results to be discussed with specialist doctor as for Enhanced although cause may not be related to OS. Consider ICSI instead of IVF.

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