If you are comparing fertility clinics, success rates and treatment costs, there is one question worth answering before any of it: what does a semen analysis measure, and have you had one? Marking Men’s Health Week (15 to 21 June), this article looks at the test that shapes which treatment, and which clinic, is actually right for you.
Male factors contribute to around half of all cases where couples have difficulty conceiving, according to the NHS. Despite this, many couples begin researching IVF before the male partner has been tested at all.
The five things a semen analysis measures
A diagnostic semen analysis assesses a sample against World Health Organization (WHO) reference values. The headline parameters are:
1. Volume. The total amount of ejaculate, with a WHO lower reference of 1.4ml. Low volume can affect how many sperm reach the cervix.
2. Concentration. Sperm per millilitre. The WHO lower reference value is 16 million/ml. Below this is classed as oligozoospermia (low sperm count); no sperm at all is azoospermia, which affects around 1% of men, as outlined in NHS guidance on low sperm count.
3. Total sperm count. Concentration multiplied by volume, with a lower reference of 39 million per ejaculate.
4. Motility. The percentage of sperm that are moving, and how progressively. At least 42% total motility (or 30% progressive) is the reference threshold.
5. Morphology. The percentage of sperm with a typical shape. The reference value is just 4%, which surprises many people: even in healthy fertile men, most sperm are irregularly shaped.
A result outside any of these ranges is not a diagnosis on its own. Sperm production varies, which is why NICE guidance recommends a repeat analysis, usually three months later, before drawing conclusions.
Why test before you compare clinics?
Because the result can change everything downstream.
It can change the treatment you need. Mild male factor issues may point towards IUI or lifestyle measures and a retest. More significant issues may point directly to IVF with ICSI, where a single sperm is injected into the egg. Clinics differ in their ICSI experience and pricing, so knowing you need it changes which clinics you shortlist and what you will pay.
It can save months. Sperm take roughly three months to regenerate. If your first analysis suggests room for improvement, that is a window to act before treatment begins, not after a failed cycle.
It can save money. A semen analysis costs a fraction of a single IVF cycle. Discovering a significant male factor issue after paying for treatment designed around a different assumption is an expensive way to learn.
It puts both partners in the conversation. Treatment decisions made with half the picture tend to be revisited later.
Where to get tested
There are three main routes in the UK:
• NHS: via your GP, normally once you have been trying to conceive for 12 months. Free, but waiting times vary by area.
• Private clinics: widely available, typically £150 to £300+ for analysis alone, often as part of a fertility work-up.
• At-home services: a kit is posted to you, your sample travels to an accredited lab in temperature-controlled packaging, and results are reviewed with a clinician remotely. Services such as the Malebox home sperm test include a consultation with an HCPC-registered clinician, so you understand your numbers rather than just receiving them.
Whichever route you choose, look for analysis performed to WHO standards and results explained by a qualified professional.
Frequently asked questions
Q: Should I get a sperm test before IVF?
A: Yes. A semen analysis is a standard part of any pre-IVF work-up, and the result influences whether conventional IVF or ICSI is recommended. Having a recent analysis before consultations means clinics can give you accurate treatment plans and quotes from the first appointment.
Q: How accurate are at-home sperm tests?
A: It depends on the type. Kits analysed in an accredited lab to WHO standards are as accurate as a clinic test, because the same analysis is performed. Instant-result devices that only estimate concentration give a much narrower picture and can miss motility and morphology issues.
Q: What is a bad semen analysis result?
A: Results below WHO reference values, such as concentration under 16 million/ml or total motility under 42%, indicate reduced fertility potential rather than infertility. Clinicians usually recommend a repeat test after three months before making treatment decisions.
Q: How much does a semen analysis cost in the UK?
A: Free on the NHS with a GP referral, usually after 12 months of trying to conceive. Privately, expect £150 to £300+ at a clinic. At-home services with full lab analysis and a clinical consultation, such as Malebox Health, sit at around £240 or £220 with the Malebox Discount Code TOTAL20.
Choosing a fertility clinic is one of the bigger decisions a couple makes, and it deserves complete information. This Men’s Health Week, before comparing success rates and price lists, make sure the male half of the equation has been measured. It is the single test most likely to change which option is right for you.
Medical disclaimer: This article is for educational purposes only and does not constitute medical advice, diagnosis or treatment. Always speak to a qualified healthcare professional about any fertility or health concerns.