How a Semen Analysis Works in India – Cost, WHO Standards & Tips to Improve Sperm Quality

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written by Philomena Marx9 June 2025
Laboratory scene: microscopic evaluation of a semen sample

For many couples in India unable to conceive, a semen analysis is often the first clear step in assessing male fertility. Modern laboratories use digital methods aligned with WHO guidelines to check whether sperm concentration, motility and morphology are sufficient to fertilise an egg. This guide explains how the test is performed in India, what it costs locally, the current WHO reference ranges and which evidence-based measures can reliably improve your sperm quality.

What Is a Semen Analysis?

A semen analysis (or sperm count) is a laboratory test that evaluates male fertility by measuring:

  • Sperm concentration – number of sperm per millilitre
  • Motility – percentage of moving sperm (progressive and non-progressive)
  • Morphology – percentage of normally shaped sperm
  • Volume – total ejaculate fluid
  • Vitality – percentage of live sperm, indicating cell integrity
  • pH – acidity/alkalinity, which can signal inflammation
  • White blood cells – elevated levels may indicate infection

Together, these parameters provide a reliable overview of whether natural conception is likely.

When Is a Semen Analysis Recommended?

Indian Council of Medical Research protocols suggest offering a semen analysis after 12 months of regular unprotected intercourse without conception, or sooner if the male partner has risk factors.

  • History of varicocele or testicular surgery
  • Undescended testicles in childhood
  • Previous chemotherapy or radiotherapy
  • Repeated miscarriages in partner
  • Abnormal hormone levels

Semen Analysis – Cost & Public Coverage

In India, semen analysis is generally available free of cost at government hospitals under Ayushman Bharat or state health schemes. Private diagnostic centres in metropolitan areas charge between ₹3,000 and ₹5,000. Many fertility clinics include a repeat analysis in a package; always confirm coverage with your provider.

How It’s Done: Preparation & Sample Collection

Preparation

  • Abstain from ejaculation for 3–5 days
  • Avoid alcohol, tobacco and recreational drugs for 48 hours beforehand
  • No fever, severe infection or extended sauna use
  • Ensure adequate sleep and minimise stress

Sample Collection

  • Wash hands and genitals with water and mild soap only
  • Do not use lubricants or oil-coated condoms, which can affect sperm
  • Collect the entire ejaculate in the sterile container provided

If collecting at home, keep the sample close to body temperature (around 37 °C) and deliver it to the lab within 60 minutes.

WHO Reference Ranges (6th Edition, 2021)

According to the WHO Laboratory Manual , the following minima apply:

  • Volume: ≥ 1.5 mL
  • Concentration: ≥ 15 million/mL
  • Total count: ≥ 39 million per ejaculate
  • Total motility: ≥ 40 % moving
  • Progressive motility: ≥ 32 %
  • Morphology: ≥ 4 % normal forms
  • Vitality: ≥ 58 % live sperm
  • pH: ≥ 7.2

Values below these thresholds indicate reduced fertility potential but do not necessarily confirm infertility.

Laboratory Quality: What to Look For

Accuracy depends on lab accreditation. In India, choose NABL-accredited centres or those participating in external quality assessments (e.g. Indian Quality Council), following WHO protocols. Ideally, two technicians should assess each sample independently.

Turnaround & Reporting

Microscopy takes around 60–120 minutes. Most labs issue a complete report within 2–4 working days, often via secure online portal, followed by a discussion with your doctor.

Interpreting Abnormal Results

  • Oligozoospermia – low sperm count
  • Asthenozoospermia – reduced motility
  • Teratozoospermia – abnormal morphology
  • Kryptozoospermia – extremely low concentration
  • Azoospermia – no sperm detected

To account for natural variations, clinicians often recommend repeating the test about six weeks later.

Common Causes of Poor Sperm Quality

  • Hormonal imbalance (testosterone, FSH, LH, prolactin)
  • Genetic factors (e.g. Klinefelter syndrome)
  • Infections (chlamydia, mumps orchitis)
  • Lifestyle: smoking, alcohol use, obesity, chronic stress
  • Environmental toxins: heat, pesticides, plasticisers

Temporary factors like fever or certain medications can also lower sperm parameters.

6 Evidence-Based Ways to Improve Sperm Quality

  • Nutrition: antioxidants (vitamins C, E, zinc), omega-3, plenty of fruit and vegetables
  • Exercise: regular moderate activity; avoid excessive heat (long bike rides, hot tubs)
  • Quit smoking & limit alcohol: reduce toxin exposure
  • Stress management: meditation, yoga, breathing exercises
  • Keep testes cool: loose underwear, avoid laptops on lap
  • Supplements: coenzyme Q10, L-carnitine may help—consult your doctor first

A meta-analysis ( Nagy et al., 2021 ) confirms lifestyle changes can significantly boost sperm count and motility.

Advanced Testing & Fertility Treatments

If results are concerning, your specialist may recommend:

  • Comprehensive hormone panel
  • Genetic testing (karyotype, Y-chromosome microdeletion)
  • Scrotal ultrasound
  • DNA fragmentation assay
  • Testicular sperm extraction (TESE/MESA) for azoospermia

Assisted reproduction techniques like IVF or ICSI can help achieve pregnancy despite male-factor issues.

Normal Results—What’s Next?

A normal semen analysis rules out most male factors. If conception still does not occur, evaluation of the female partner—cycle monitoring, hormone tests or postcoital testing—may be advised. A fertility specialist can coordinate a comprehensive assessment.

Conclusion

A semen analysis provides objective data on male fertility potential. Abnormalities can often be addressed with lifestyle changes, targeted treatments and assisted conception. When results are normal, a joint approach by both partners offers the best chance of success—fertility truly is a team effort.

Frequently Asked Questions (FAQ)