Men's Fertility Hub

On the day of your scheduled semen analysis appointment, you will arrive at Illume Fertility and check in with our friendly front desk team. A member of our Andrology Lab team will meet you in the waiting area and guide you to a private collection room.

Note: Your partner may accompany you, but no oral sex is allowed (since saliva can affect the integrity of the sample). 

You will collect the sample via masturbation and speak to the Andrology Team for final steps before leaving.

Your labeled sample will then be passed through to our on-site Andrology Lab, where specialists evaluate key factors: count (concentration), motility, morphology, and volume, and calculate total motile sperm (TMS). If results are borderline or abnormal, a repeat analysis may be recommended since values naturally fluctuate over time. 

At-Home Collection

Prefer not to produce a sample on-site? Ask for a home collection kit and bring your sample to the office within 45 minutes, keeping it as close to body temperature as possible.

Patients should not use any store-bought lubricant as it can damage the sample and lead to inaccurate results. Illume will supply an approved lubricant in each collection kit. 

Your team will provide step-by-step instructions beforehand and answer any questions you may have.

Note: If you choose at-home collection, the male patient (sperm source) must deliver the specimen to Illume Fertility. The only exception to this rule is for a semen analysis, where a designated partner may deliver the specimen for the patient.

Religious Accommodations

For patients requiring religious accommodations, special condoms may be used for collection via intercourse at home. 

Illume partners with ATIME to offer a chain of custody observation program for religious patients. 

A semen analysis looks at how many sperm are present, how they move, their shape, and the overall volume and quality of the sample. These factors help us understand how well sperm may be able to reach and fertilize an egg. Here's what we measure:

Count (Concentration)

This tells us how many sperm are present in each milliliter of semen. A common reference range for normal concentration is 15 million sperm per mL or higher. A sperm concentration below 15 million sperm per mL is considered lower than average. Even so, sperm count alone does not determine whether pregnancy is possible. Many people with lower counts are still able to conceive, and sometimes those with higher counts may still need support.

If the count is significantly low, your doctor may recommend undergoing genetic testing (via a simple blood test) to help us understand whether a chromosomal factor may be contributing.

Volume

This is the total amount of semen in the sample. A volume of 1.5 mL or more is considered within a normal range. Low volume can occur for simple reasons, like not capturing the full sample, or from partial retrograde ejaculation, where some semen flows back into the bladder. In these cases, we may ask for a second sample after emptying the bladder to get an accurate result.

When both volume and sperm concentration are low, this may relate to hormone levels. If volume is very low with no sperm (called azoospermia) or very low sperm (severe oligospermia), it may suggest a blockage.

Motility

This describes how well sperm move. Sperm need to "swim" forward efficiently to reach the egg. Ideally, at least 40% of sperm are moving effectively. However, unless all of the sperm show poor movement, low motility alone is not a predictor of infertility.

Morphology

This refers to sperm shape and structure. A commonly used normal reference is 4% or more morphologically normal sperm. This may sound like a low number, but it is typical and not a cause for alarm by itself.

Morphology is evaluated under a high-powered microscope, where our Andrology Team closely examines each part of the sperm to see how many have a normal head, midpiece, and tail. Here's why:

1. The head carries genetic material and helps attach to the egg.
2. The midpiece provides energy for movement.
3. The tail helps the sperm move forward.

Healthy sperm typically have oval heads and long tails that help them swim towards the egg. If a higher percentage of sperm have irregular shapes, it may be harder for them to move effectively or attach to the egg. This is called abnormal morphology.

Most Illume Fertility patients receive the results of their semen analysis within 7 days, though some test results may take longer.

Patients referred by a urologist will receive their results directly from the urologist within 7 days. 

Patients referred by a primary care provider or OB-GYN will receive a call from an Illume Fertility physician within 7 days.

If you haven’t received your results yet, please contact your referring provider directly for an update.

An abnormal semen analysis result on its own does not equal infertility. Sperm counts can vary from day to day, and results may be affected by lifestyle factors, stress, or recent illness. Your doctor may recommend repeating the test in a few weeks or exploring further evaluation.

Sperm develop in cycles over about 2 to 3 months, and levels can often improve with:

• Lifestyle and nutrition support
• Medication or hormonal treatment
• Varicocele repair, if present
• IUI or IVF with ICSI

Most patients have multiple options, even with results outside of the normal range. Your Illume physician or referring urologist will help you interpret your test results and determine the best next step.

When sperm are not present in the semen (a condition called azoospermia that can be caused by a blockage, prior vasectomy, genetic condition, or low production), there may still be healthy sperm available in the reproductive system. In these cases, sperm can often be retrieved directly and used with IVF and ICSI to fertilize eggs.

The following procedures are performed by a reproductive urologist working closely with your fertility clinic team.

Microsurgical Epididymal Sperm Aspiration (MESA)

MESA is a microsurgical procedure performed with a high-powered operating microscope to carefully retrieve sperm from the epididymis. It is often recommended when a blockage is present or when a larger amount of sperm is needed for multiple IVF attempts or future family-building. This approach allows sperm to be retrieved in a controlled way and can provide enough sperm for freezing and later use.

Testicular Sperm Aspiration/Extraction (TESA or TESE)

TESA/TESE retrieves sperm directly from testicular tissue when sperm count is extremely low or sperm are not present in the semen due to a production issue. In this approach, a small tissue sample is taken from the testicle and examined in the lab to locate usable sperm.  Even if no sperm are seen in the ejaculate, sperm found in the testes can often be used successfully with IVF and ICSI.

Percutaneous Epididymal Sperm Aspiration (PESA)

PESA is a quick outpatient procedure that uses a very thin needle to retrieve sperm from the epididymis, the small tube where sperm are stored before ejaculation. This option is commonly used when sperm are being produced normally but cannot reach the semen because of a blockage or a prior vasectomy. The retrieved sperm are used during IVF with ICSI, where a single sperm is injected directly into each mature egg.