In the process of diagnosing and treating male infertility, routine semen examination is an essential component, and semen analysis is an important indicator of male fertility. However, a clinical semen analysis report form can contain as many as 40 to 50 indicators, so which indicators are the most important? What are the most important indicators of male fertility? To determine whether a man’s semen is normal, we mainly look at semen volume, sperm density, sperm motility, sperm malformation rate, semen pH value, sperm viability and other indicators. A man with normal semen may not necessarily be able to have children, and a man with abnormal semen may not be absolutely infertile. How to read the semen analysis report? 1. Semen volume: the normal range of values is 2 to 6 ml Semen volume refers to the amount of semen discharged per ejaculation. The normal semen volume is 2 to 6 ml, and the minimum needed is 1.5 to 2 ml. If it is lower than this value, it means that the semen volume is a bit low, and may even be oligospermia. Of course, the more semen is not the better, if the semen volume is too much, you need to exclude whether it is a pathological “more”. 2, sperm density: 15 million per ml is considered normal Sperm density refers to the number of sperm per unit volume. Now, a sperm density of 15 million per ml is already considered normal. However, 30 years ago, the sperm density required to reach 60 million to 200 million per milliliter. It can be said that the reproductive capacity of men is now greatly degraded. This degradation is not unrelated to the current environment and people’s lifestyles. For example, people are now driving more, walking less, sitting for long hours and exercising less. Sperm density less than 15 million/ml is considered oligospermia, and the chances of sperm entering the uterine cavity and fallopian tubes will be reduced, thus leading to a reduced ability to conceive; however, if it exceeds 200 million/ml, it is considered polyspermia, and sperm motility will be affected, which will likewise affect the ability of sperm to conceive. Therefore, high sperm density, low sperm density and even azoospermia are all male infertility factors. 3, sperm motility: straight forward motion sperm to ≥ 32% sperm motility is generally divided into four levels. level 0 refers to inactive sperm; level 1 refers to sperm moving in place; level 2 is slow forward curve swimming sperm; level 3 is straight forward swimming sperm; level 4 is fast straight forward swimming sperm. In general, sperm of level 3 or higher are required to fertilize the egg. To successfully conceive, the ratio of grade 3 sperm plus grade 4 sperm is generally required to be greater than 32%. 4. Sperm viability and malformation rate: more than 58% and less than 96% respectively The sperm viability is also important. Viability usually refers to the proportion of sperm with motility within one hour after ejaculation. Normally, the sperm viability rate should be above 58%. Similarly, the sperm malformation rate also affects the ability of sperm to conceive. A sperm malformation rate of 92% or less is a more desirable indicator. “If it can be below 96 percent it is considered passable.” In fact, the standards for sperm viability and malformation rates have also been lowered. 5, semen PH: most of them are stable at around 7.1 The majority of semen PH is stable at around 7.1 when the pH of semen is normal. Too high or too low may be due to inflammation. If there is inflammation, it will naturally affect conception as well. 6, semen color: regular ejaculation male semen is milky white In addition, the appearance of semen also needs attention. Under normal circumstances, if a man has regular semen discharge, semen should be milky white; if there is no semen discharge for a longer period of time, the color of semen will be light yellow; if the color of semen is red, there may be blood in the semen; if the color of semen is very yellow and thick, there may be pus cells. Determining semen quality: three tests are needed All these indicators of semen testing are flexible. There are many factors that affect semen quality, including congenital factors, such as poor testicular congenital development; and acquired factors, such as work stress, eating habits, sleep, and emotions may affect the quality of semen. Therefore, even if a person is examined every time, his semen quality may not always be the same. Therefore, even if the semen is not normal at the first examination, it does not necessarily mean that his semen is not normal. Generally it takes three examinations at different points in time to make a judgment and to understand the fluctuating range of the patient’s semen parameters. Judging semen quality: not the only criterion for fertility At present, all semen examinations are morphological and it is not yet possible to do a functional examination. Therefore, whether semen is normal or not is not an “iron standard” for determining fertility, as there are many factors that affect fertility. Normal semen does not necessarily mean fertility, as some immune or other unrecognized factors that cause male infertility cannot be ruled out. “For example, there are couples where there is no problem with the quality of the male partner’s sperm and the female partner’s eggs, but they just can’t conceive.” This is primarily a problem where there is a disorder of sperm and egg binding. Similarly, abnormal semen does not necessarily mean that you can’t have children. “For example, some men may succeed in getting pregnant even though their sperm density is less than 20 million/ml, due to their high sperm motility and low malformation rate, or their wife’s exceptional fertility.” Therefore, a semen laboratory test requires a comprehensive analysis of the results of each test. It is important to note that the causes of male infertility are complex, and testicular factors, blocked vas deferens, and ejaculatory disorders may all be factors in infertility. It is also important to consider the fertility of his partner.