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Semen analysis - WHO 2021, done properly.

A proper semen analysis is a lab test, not a home-kit gimmick. WHO 2021 reference values, careful sample handling, and consultant review - because one abnormal test never diagnoses infertility.

A stethoscope on a clinical desk

Indicative pricing

What a private semen analysis costs in the UK.

Indicative ranges across UK fertility test units.

In short

£120–£300, report in 3–5 working days.

Procedure Indicative range
Standard semen analysis (WHO 2021) £120–£200
Extended (adds strict-criteria morphology, vitality) £180–£280
Sperm DNA fragmentation test £200–£350
Post-vasectomy semen analysis £120–£200
Full male fertility workup (bloods + US + semen) £450–£800
Andrology consultation only £200–£400

Prices vary by whether DNA fragmentation testing, morphology by strict criteria, or sperm cryopreservation are added.

The problem

One abnormal test is not a diagnosis.

Semen parameters swing week to week. Illness, fever, sauna use and abstinence all shift the numbers. A useful workup uses two samples 6 weeks apart, WHO 2021 reference values, and a consultant who explains what the numbers actually mean.

  • Repeat before you worry

    Semen parameters swing. Two samples 6 weeks apart, WHO 2021 values.

  • Volume, count, motility, morphology

    Each measures a different thing. Isolated abnormalities are common.

  • A specialist matters

    A good report leads to further tests (DNA fragmentation, hormones, imaging) only when they change management.

When it helps

When a semen analysis is the right step.

Situations where the test earns its place - plus the red flag that trumps a test.

  • Unexplained subfertility

    After 12 months (or 6 months if the female partner is 35+) of trying.

  • Pre-chemotherapy fertility preservation

    Before treatment, sperm cryopreservation offered.

  • Post-vasectomy confirmation

    Two negative samples at 12 and 16 weeks before relying on it.

  • Prior testicular surgery or torsion

    Baseline post-recovery.

  • Varicocele or scrotal pathology

    Assess fertility impact and pre-surgery baseline.

  • Suspected endocrine disorder

    Testosterone deficiency, hypogonadism - semen alongside bloods.

  • Recurrent miscarriage evaluation

    Sperm DNA fragmentation sometimes tested alongside standard analysis.

  • Red flag: testicular lump or pain

    A new lump, sudden severe pain or swelling needs urgent urology or A&E, not a fertility booking.

Procedure options

Beyond standard semen analysis.

When to add DNA fragmentation, hormones or imaging.

  • Standard WHO 2021 analysis

    Volume, concentration, motility, morphology, vitality.

  • Strict-criteria morphology (Kruger)

    Stricter definition - more sensitive marker of subfertility.

  • Sperm DNA fragmentation

    Optional - for recurrent miscarriage or unexplained IVF failure.

  • Hormonal panel

    Testosterone, FSH, LH, prolactin - useful when azoospermia or severe oligospermia.

  • Scrotal ultrasound

    Varicocele, testicular volume, epididymal cysts.

  • Genetic testing

    Karyotype, Y-chromosome microdeletion, CFTR - for severe oligospermia or azoospermia.

  • Cryopreservation

    Sperm banking before chemotherapy, surgery or vasectomy.

  • Repeat testing

    Two samples 6 weeks apart before diagnostic labels.

Safety and recovery

What to expect afterwards - honestly.

The safety profile is well understood. What matters is choosing the right test, and reading the report honestly.

  • The test itself is safe

    Sample production is by masturbation. No physical risk.

  • Sample handling is critical

    Deliver within 1 hour at body temperature - in-clinic collection avoids the issue.

  • Illness affects results

    Fever, illness or infection in the last 6 weeks can transiently drop counts.

  • Sauna and heat

    Regular sauna, hot tub or fever drops motility.

  • Abstinence window

    2–7 days is standard. Extremes shift results.

  • One abnormal test needs repeating

    Never diagnose subfertility on a single sample.

  • Emotional impact

    Abnormal results are common and unsettling - proper counselling is part of the service.

  • Not for teens without symptom or plan

    Testing without indication risks unnecessary anxiety.

  • When to escalate

    A testicular lump, sudden pain or swelling - urgent urology or A&E.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever centre does the scan, the report keeps to the same shape.

A UK consultant reviewing operation notes

A quiet reminder

Surgical language is precise and can read coldly - it helps to have it explained in plain English.

If anything in the operation note or histology is unclear, ask your clinician to talk you through it before your review.

  1. 01 Header

    Sample details

    Abstinence, collection method, volume, appearance.

  2. 02 Findings

    WHO 2021 parameters

    Volume, concentration, total number, progressive and total motility, morphology, vitality.

  3. 03 Comparison

    Comparison with prior samples

    If any, direction of change since previous test.

  4. 04 Impression

    Category and next step

    Read this first - normozoospermia, oligo/astheno/teratozoospermia, azoospermia - and the recommended next step.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Fertility investigations are usually excluded from UK private medical insurance. Post-vasectomy checks and urology-referred testing may be covered.

Frequently asked

Common questions about semen analysis.

Quick answers on approach, recovery, risks and cost.

  • What is measured in a semen analysis?

    Per WHO 2021: volume, sperm concentration, total sperm number, progressive and total motility, morphology and vitality. Extended tests add strict-criteria morphology and DNA fragmentation.

  • How much does a private semen analysis cost in the UK?

    £120–£200 for a standard WHO 2021 analysis; £180–£280 with strict-criteria morphology and vitality; £200–£350 for DNA fragmentation; £450–£800 for a full male fertility workup.

  • Does one bad test mean I’m infertile?

    No. Semen parameters swing week to week. Two samples 6 weeks apart, both consistent with impaired fertility, are needed before any diagnostic label.

  • How long should I abstain before the test?

    Two to seven days. Under 2 days lowers volume; over 7 days lowers motility. Illness, fever or heavy sauna use in the preceding 6 weeks should be noted.

  • Is the test covered by insurance?

    Fertility investigations are usually excluded from UK PMI. Post-vasectomy checks and testing for a specific urological problem may be covered with a referral.

  • Can I collect the sample at home?

    Yes at some clinics, provided the sample is delivered within an hour and kept at body temperature. In-clinic collection avoids handling problems and is preferred by most labs.

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