Test Catalog

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 No 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

Semen Analysis with Strict Morphology

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


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)



-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:

1. After collection, allow the specimen to liquefy for 1 hour.

2. Measure the volume.

3. Place the specimen into media within 1 hour.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

See Specimen Required

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

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 of these 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.


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.



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)

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.

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.

1 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

See Individual Test IDs

Performing Laboratory Location
Indicates the location of the laboratory that performs the test


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 Regional Manager. 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.

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 6800-7
GR2 Grade 13942-8
MOTEJ Motile/Ejaculate 6800-7
VISC Viscosity 32789-0
AGGLU Agglutination 33217-1
STAIN Supravital Stain 4466-9
FRCT Fructose 13943-6
CMT45 Comment 48767-8
OVAL2 Strict Morph NL 10622-9
ACRSM Acrosom Defect 66494-6
HDSAB Head Shape Abnormal 66495-3
HDZAB Head Size Abnormal 66496-1
MD Midpiece Defect 10603-9
TAILD Tail Defect 10604-7
DBLF Double Forms 66497-9
MULTI Multiple Defects 66498-7
GERM3 Germ Cells/mL 10576-7
WBC6 WBC/mL 10579-1
CMT56 Comment 48767-8

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports