Test Id : SEMB
Semen Analysis with Strict Morphology, Semen
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining male fertility status
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and white blood cells per milliliter of semen
Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| FER | Semen Analysis | Yes | Yes |
| MSTC | Strict Criteria Sperm Morphology | Yes | Yes |
Method Name
A short description of the method used to perform the test
FER: Manual
MSCT: Kruger Criteria Strict Morphology
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Fertility Testing
Infertility Testing
Semen Analysis with WHO Morphology
Semen Concentration
Semen Count
Semen Motility
Semen Volume
Sperm Analysis
Sperm Count
Sperm Motility
Sperm Volume
Specimen Type
Describes the specimen type validated for testing
Semen
Ordering Guidance
This test should not be used to check patient's sterility following a vasectomy. For such cases, order POSV / Post Vasectomy Check, Semen.
Semen analysis specimens submitted to Mayo Clinic Laboratories are not acceptable for fructose testing due to the use of dilution media. For specimen requirements for fructose testing in azoospermia patients, see FROS2 / Fructose, Qualitative, Semen.
Submit separate specimen to rule-out ejaculatory duct blockage. Positive result indicates no blockage.
Shipping Instructions
Specimen must arrive within 24 hours of collection. Send specimen Monday through Thursday only and not the day before a holiday. If holiday falls on a Saturday, holiday will be observed on the preceding Friday. Sunday holidays are observed on the following Monday. Specimen should be collected and packaged as close to shipping time as possible. Laboratory does not perform testing on weekends.
Necessary Information
Include the following information:
-Semen volume (required)
-Viscosity
-pH
-Appearance (color)
-Number of days of sexual abstinence
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Patient Preparation: Patient should have 2 to 7 days of sexual abstinence at the time of semen collection for accurate results.
Supplies: Semen Analysis Kit - Dilution Media (T178)
Specimen Volume: Total ejaculate
Collection Instructions:
See Semen Collection Specimen Preparation and Packaging Instructions included with the kit
1. Prior to use, allow dilution medium to warm to room temperature for 45 to 60 minutes.
2. Allow semen to liquefy at room temperature for up to 30 minutes.
3. Use sterile volumetric pipet or tube for volume measurement.
4. Pour liquefied semen into 50-mL dilution medium container within 60 minutes of semen collection time, cap tightly, but do not overtighten, and gently mix.
Note: Proper temperature maintenance of specimen throughout processing and shipping is critical. All materials the specimen is exposed to should be at room temperature (20–28 degrees C).
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
See Specimen Required
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Semen | Ambient | 36 hours |
Useful For
Suggests clinical disorders or settings where the test may be helpful
Determining male fertility status
Selecting the most cost-effective therapy for treating male-factor infertility
Quantifying the number of germinal and white blood cells per milliliter of semen
Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Infertility affects 1 out of 6 couples of child-bearing age. Approximately 40% of infertility has a female-factor cause and 40% a male-factor cause. The remaining 20% of infertility is due to a combination of male- and female-factor disorders or is unexplained.
Semen is composed of spermatozoa suspended in seminal fluid (plasma). The function of the seminal fluid is to provide nutrition and volume for conveying the spermatozoa to the endocervical mucus. Male infertility can be affected by a number of causes. Chief among these is a decrease in the number of viable sperm. Other causes include sperm with abnormal morphology and abnormalities of the seminal fluid. One of the more successful treatments for male and female infertility is in vitro fertilization (IVF). Male partners are tested with the strict criteria sperm morphology test prior to IVF to assist in the diagnosis of male-factor defects.
Abnormalities in sperm morphology are related to defects in sperm transport, sperm capacitation, the acrosome reaction, binding and penetration of the zona pellucida, and fusion with the oocyte vitelline membrane. All steps are essential to normal fertility.
Strict criteria sperm morphology testing also greatly assists with selecting the most cost-effective in vitro sperm processing and insemination treatment for the couple's IVF cycle. Sperm with severe head abnormalities are unlikely to bind to the zona pellucida. These patients may require intracytoplasmic sperm injection in association with their IVF cycle to ensure optimal levels of fertilization are achieved. This, in turn, provides the patient with the best chance of pregnancy.
Multiple semen analyses are usually conducted over the course of the spermatogenic cycle (approximately 70 days).
Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
SEMEN ANALYSIS
Appearance: normal
Volume: > or =1.5 mL
pH: > or =7.2
Motile/mL: > or =6.0 x 10(6)
Sperm/mL: > or =15.0 x 10(6)
Motility: > or =40%
Grade: > or =2.5
Note: Multiple laboratory studies have indicated that semen parameters for motility and grade on average retain 80% of original parameters when our shipping method is used for transport. Using these averages, samples with 32% to 39% motility and grade of 2 may be in the normal range if testing was performed shortly after collection. Therefore, these borderline patients may need to collect another sample at a local fertility center to verify fertility status.
Motile/ejaculate: > or =9.0 x 10(6)
Viscosity: > or =3.0
Agglutination: > or =3.0
Supravital: > or =58% live
Fructose: positive
Note: Fructose testing cannot be performed on semen analysis specimens shipped through Mayo Clinic Laboratories. If patient is azoospermic, refer to FROS2 / Fructose, Qualitative, Semen. Submit separate specimen to rule-out ejaculatory duct blockage. Positive result indicates no blockage.
STRICT MORPHOLOGY
Normal forms: > or =4.0% normal oval sperm heads
Germ cells: <4 x 10(6) (normal)
> or =4 x 10(6)/mL (elevated germinal cells in semen are of unknown clinical significance)
White blood cell count:
<1 x 10(6) (normal)
> or =1 x 10(6)/mL (elevated white blood cells in semen are of questionable clinical significance)
Interpretation
Provides information to assist in interpretation of the test results
Semen specimens can vary widely in the same man from specimen to specimen. Semen parameters falling outside of the normal ranges do not preclude fertility for that individual. Multiple samples may need to be analyzed prior to establishing patient’s fertility status.
Sperm are categorized according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head/tail size/shape may not be capable of completing critical steps in sperm transport and fertilization.
Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Results may be unreliable if specimen transportation requirements are not followed.
Clinical Reference
Recommendations for in-depth reading of a clinical nature
1. WHO laboratory manual for the examination of human semen and processing. 5th ed. World Health Organization; 2010
2. WHO laboratory manual for the examination and processing of human semen. 6th ed. World Health Organization; 2021
Method Description
Describes how the test is performed and provides a method-specific reference
Semen Analysis:
The sample is measured for volume and analyzed microscopically to determine the number of sperm present, the number of moving or motile sperm, and the properties of the sperm motility.(WHO laboratory manual for the examination and processing of human semen. 6th ed. World Health Organization; 2021)
Strict Morphology:
Sperm is categorized according to strict criteria based on measurements of head and tail sizes and shapes. Sperm with abnormalities in head/tail size/shape are not capable of completing steps in the sperm transport and fertilization process. Quantification of germinal and white blood cells (WBC) in semen is performed because the presence of germinal and WBC may indicate disorders in spermatogenesis and genital tract inflammation, respectively. The information collected will help to determine the most cost-effective therapy for treating male-factor infertility.(Wazzan W, Thomas A: Genital infection and male infertility. AFS Annual Meeting, Postgraduate course, 1990; Menkveld R, Oettle E, Kruger T, et al: Atlas of Human Sperm Morphology. Williams and Wilkins, 1991; Scoring is based on a modified method of WHO laboratory manual for the examination and processing of human semen. 6th ed. World Health Organization; 2021)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Friday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
89310-Semen Analysis
89398-Strict Criteria Sperm Morphology
If both components performed,
89322-Semen Analysis with Strict Morphology
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| SEMB | Semen Analysis with Strict Morphology | 54231-6 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| ABSTN | Abstinence | 10587-4 |
| CLST1 | Collection Site | 56816-2 |
| TY | Study Type | 54453-6 |
| CNTN | Container Type | 74384-9 |
| APP3 | Appearance | 13359-5 |
| VL53 | Semen Volume | 3160-9 |
| PH1 | pH | 2752-4 |
| MOTML | Motile/mL | 42531-4 |
| SPML | Sperm/mL | 9780-8 |
| MOTY | Motility | In Process |
| GR2 | Grade | 13942-8 |
| MOTEJ | Motile/Ejaculate | In Process |
| VISC | Viscosity | 32789-0 |
| AGGLU | Agglutination | 33217-1 |
| STAIN | Supravital Stain | 101570-0 |
| FRCT | Fructose | 13943-6 |
| CMT45 | Comment | 48767-8 |
| OVAL2 | Strict Morph NL | 10622-9 |
| ACRSM | Acrosom Defect | In Process |
| HDSAB | Head Shape Abnormal | In Process |
| HDZAB | Head Size Abnormal | In Process |
| MD | Midpiece Defect | 10603-9 |
| TAILD | Tail Defect | 10604-7 |
| DBLF | Double Forms | In Process |
| MULTI | Multiple Defects | In Process |
| GERM3 | Germ Cells/mL | 10576-7 |
| WBC6 | WBC/mL | 10579-1 |
| CMT56 | Comment | 48767-8 |