Quality statement 4: Semen analysis

Quality statement

Services analysing semen samples use methods and reference values in accordance with the most recent World Health Organization laboratory manual.

Rationale

Semen analysis is the primary assessment tool for male fertility potential. The accuracy of the result is dependent on following accredited methods of analysis that are regularly audited and subject to quality control. Variations in laboratory techniques significantly influence the reliability of the results of semen analysis. This may lead to a longer process for investigating male infertility, and possibly to inappropriate treatment.

Quality measures

Structure

Evidence of a quality assurance programme to ensure that services analysing semen samples use methods and reference values in accordance with the most recent World Health Organization laboratory manual.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (laboratory services) ensure that there is a quality assurance programme in place so that services analysing semen samples use methods and reference values in accordance with the most recent World Health Organization laboratory manual.

Healthcare professionals (such as scientists and laboratory technicians) analysing semen samples use methods and reference values in accordance with the most recent World Health Organization laboratory manual.

Commissioners (clinical commissioning groups) ensure that the laboratory services they use comply with the most recent World Health Organization laboratory manual.

What the quality statement means for patients

Men having their semen checked to measure the quantity and quality of their sperm have it tested by a laboratory that uses recommended methods to provide an accurate result.

Source guidance

  • Fertility (2013) NICE guideline CG156, recommendation 1.3.1.1.

Definitions of terms used in this quality statement

Reference values

The results of the semen analysis conducted as part of an initial assessment should be compared with the following World Health Organization reference values:

  • semen volume: 1.5 ml or more

  • pH: 7.2 or more

  • sperm concentration: 15 million spermatozoa per ml or more

  • total sperm number: 39 million spermatozoa per ejaculate or more

  • total motility (percentage of progressive motility and non‑progressive motility): 40% or more motile or 32% or more with progressive motility

  • vitality: 58% or more live spermatozoa

  • sperm morphology (percentage of normal forms): 4% or more.

The reference ranges are only valid for the semen analysis tests outlined by the World Health Organization.

[Fertility (NICE guideline CG156), recommendation 1.3.1.1]