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Test Code SEMB Semen Analysis with Strict Morphology

Useful For

Determining male fertility status


Selecting the most cost-effective therapy for treating male-factor infertility


Quantifying the number of germinal and WBCs per mL of semen

Profile Information

Test ID Reporting Name Available Separately Always Performed
FER Semen Analysis No Yes
MSTC Strict Criteria Sperm Morphology No Yes

Reporting Name

Semen Analysis with Strict Morphology

Specimen Type


Advisory Information

Semen analysis specimens submitted to Mayo Medical Laboratories are not acceptable for fructose testing due to the use of dilution media. See FROS / Fructose, Semen or Seminal Plasma for specimen requirements for fructose testing in azoospermia patients.


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

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 Stability Information

Specimen Type Temperature Time
Semen Ambient 36 hours

Reject Due To










Clinical Information

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


Appearance: normal

Volume: ≥1.5 mL

pH: ≥7.2

Motile/mL: ≥6.0 x 10(6)

Sperm/mL: ≥15.0 x 10(6)

Motility: ≥40%

Grade: ≥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: ≥9.0 x 10(6)

Viscosity: ≥3.0

Agglutination: ≥3.0

Supravital: ≥58% live

Fructose: positive

Note: Fructose testing cannot be performed on semen analysis specimens shipped through Mayo Medical Laboratories. If patient is azoospermic, refer to FROS / Fructose, Semen or Seminal Plasma. Submit separate specimen to rule-out ejaculatory duct blockage. Positive result indicates no blockage.



Normal forms: ≥4.5% normal oval sperm heads

Germ cells: <4 x 10(6) (normal)

≥4 x 10(6)/mL (elevated germinal cells in semen are of unknown clinical significance)

WBC: <1 x 10(6) (normal)

≥1 x 10(6)/mL (elevated white blood cells in semen are of questionable clinical significance)


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.

Day(s) and Time(s) Performed

Monday through Friday; 3 p.m.

Send specimen Monday through Thursday only and not the day before a holiday.

Analytic Time

1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

89310-Semen Analysis

89398-Strict Criteria Sperm Morphology

If both components performed,

89322-Semen Analysis with Strict Morphology

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SEMB Semen Analysis with Strict Morphology In Process


Result ID Test Result Name Result LOINC Value
OVAL2 Strict Morph NL 9704-8
ACRSM Acrosom Defect 66494-6
ABSTN Abstinence 10587-4
CLST1 Collection Site 56816-2
HDSAB Head Shape Abnormal 10602-1
HDZAB Head Size Abnormal 10602-1
TY Study Type 54453-6
CNTN Container Type 74384-9
MD Midpiece Defect 10603-9
TAILD Tail Defect 10604-7
DBLF Double Forms 66497-9
MULTI Multiple Defects In Process
APP3 Appearance 13359-5
VL53 Semen Volume 3160-9
GERM3 Germ Cells/mL 10576-7
WBC6 WBC/mL 10579-1
PH1 pH 2752-4
CMT56 Comment 48767-8
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

Specimen Minimum Volume

A minimum count is needed. Lab will determine.

Clinical Reference

1. Kruger Morphology Conference, Boston, MA, October 9, 1993

2. The World Health Organization Laboratory Manual for the examination of human semen and sperm-cervical mucus interaction. Fifth edition. Cambridge University Press, 2010

Method Name

FER: Manual

MSCT: Kruger Criteria Strict Morphology