Q&A with Dr. Paul Turek, Legacy Advisor 


What is a semen analysis?

Think of sperm production as an engine that wants to run hard, at full tilt. When all is well and the body is at peak performance, the semen analysis tends to be normal. However, with ill-health, sperm production is hampered and sperm counts fall. When I do a deep dive into a man’s health and habits in the setting of impaired semen quality, it’s impressive how often I explain the male factor infertility problem.

At a clinical level, a semen analysis also known as a sperm count test, analyzes the health and viability of a man’s sperm. Semen is the fluid containing sperm (plus other sugar and protein substances) that’s released during ejaculation. A complete semen analysis includes volume, count, concentration, motility, and morphology.

Who should get a semen analysis?

Men are fortunate that a semen analysis today simply involves masturbating—it’s much more complicated for women to test their fertility. So if you’re trying to conceive, getting a semen analysis is a no-brainer, especially if it’s affordable and you can do it from home. At the very least, it will allow you to screen for any issues that might prevent you from getting pregnant.

But you should also recognize what it can and can’t tell you. It’s part of our nature to count things. Maybe, in doing so and by ordering our universe, we get a sense of belonging or control over our environment. And so for the last 100 years, we count the sperm in our semen. But unlike a blood glucose level, which is incredibly tightly regulated and on point, sperm are part of a much more loosey-goosey biological secretion that varies by year, season and even by day. This makes “normal” values or “reference” ranges for semen quality both complicated and somewhat artificial. Bottom line: unless it reads zero, the semen analysis is a poor measure of a man’s true fertility potential.

Sperm are part of a much more loosey-goosey biological secretion that varies by year, season and even by day.

When taken in full clinical context, the semen analysis can often tell a story. When viewed over time, they may reveal health-related patterns. Like the slowly declining sperm counts associated with the progressive effects of a varicocele, increased obesity or uncontrolled diabetes. More profound is the recently described relationship of semen quality as a “biomarker” of disease, mortality, and higher rates of later cancers in men. Yes, although this onion is not fully peeled, semen quality appears to be a window into men’s current and future health.

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How long does it take to receive results?

The whole process takes as a little as 3-4 days. Order on Monday, produce your sample on Tuesday, get your results on Wednesday or Thursday. 

What will the results tell me?

You’ll receive a full semen analysis, as described above, but you’ll also get personalized recommendations tailored to your lifestyle (BMI, nutrition, exercise habits, and so on). Your lifestyle and the way you treat your body has far more impact on your fertility than what a semen analysis lets you know, so if you actually make these changes, it can have a significant impact on your fertility.

Is an at-home sperm analysis as complete and accurate as the one at a clinic?

For the most part, yes. Your volume, count, concentration, and morphology will not be affected during time in transit. And if you’re using a 1-hour courier service, then the motility will not be affected, either. If you’re using an overnight shipping method, with a transport media, you can expect to see a slight decrease in motility (approximately 10%), which will be reflected in your results. 

It bears repeating that “normal” values or “reference” ranges for semen quality, while based on the World Health Organizations’s guidelines, are somewhat artificial. So the exact accuracy of a sperm analysis is less important than being able to identify issues like azoospermia (men who don’t produce sperm in their semen - about 1% of the population) or when a man is subfertile on most or all factors.

What can men do to improve sperm health?

So what’s a man to do? Should you take the Woody Allen approach and do more push ups? Maybe. The first step is to realize that health affects fertility and treat your body like a temple. Take great care of yourself and pursue a life of moderation. Avoid some things completely, such as tobacco, pot, hot tubs, and excessive alcohol. Also, eat well, sleep well, exercise, and try to reduce stress. Consider taking supplements. 

I know it seems kind of a simple recipe, but it’s more than likely that your lifestyle choices and overall health affect semen quality more than you know. I believe this from my own studies that have shown excellent natural fertility rates in men whose treatment consisted of simply and consciously made lifestyle choices.


Paul Turek, MD is an internationally renowned expert in men’s sexual health and reproductive urology. Dr. Turek is fellowship trained and board certified by the American Board of Urology. He has received countless honors and awards for his work with male infertility and has provided valuable research to the men’s sexual health community.
Dr. Paul Turek has been recognized as one of America’s Best Doctors by seven accrediting organizations (US News and World Report Top Doctors, Marquis Who’s Who, Best Doctors, PatientsChoice.org, Top MD-Consumer’s Checkbook, SuperDoctors and Castle-Connolly Top Doctors). Dr. Turek graduated from Yale College with highest honors (summa cum laude), Phi Beta Kappa, and then attended medical school at Stanford University, where he also took top research honors. He completed his residency in urology at the Hospital of the University of Pennsylvania, the nation’s first medical school, founded by Benjamin Franklin.