Semen Analysis in London: Preparation, Results and 6 FAQs
Quick answer
Semen analysis is usually the first laboratory test used to assess the male contribution to fertility. It measures several features of semen and sperm, but a single result cannot prove that a man is fertile or infertile. Follow the exact preparation and collection instructions from your London laboratory, because sample completeness, transport time and temperature can affect interpretation.
When should you consider a male fertility assessment?
The NHS advises seeking help after one year of regular unprotected sex without pregnancy, or sooner when there is a reason for concern. Assessment should consider both partners. You can read the NHS overview of infertility diagnosis and discuss timing with your GP or fertility specialist.
You have been trying to conceive for 12 months without success.
Your partner is aged 36 or over, so earlier assessment may be appropriate.
You have a history of undescended testes, testicular injury or surgery, cancer treatment, genital infection, varicocele, or ejaculation difficulties.
You use prescribed testosterone, anabolic steroids, supplements or other medicines that may affect sperm production.
You want an informed baseline assessment before fertility treatment or fertility preservation.
What does a semen analysis measure?
A diagnostic laboratory normally reports semen volume, sperm concentration, total sperm number, motility, morphology and, where relevant, vitality. Results are compared with World Health Organization reference values. These are clinical reference limits, not a pass-or-fail fertility score.
For a London laboratory example, see North West London Pathology’s diagnostic semen analysis information. Its guidance stresses a complete fresh sample in the supplied container and prompt processing. Always follow the instructions of the laboratory performing your test.
How should you prepare and collect the sample?
Use the abstinence interval specified by your laboratory rather than relying on a generic rule.
Collect the sample in the laboratory-approved, toxicity-tested container and follow the instructions exactly.
Tell the laboratory if any part of the ejaculate was missed or spilt; an incomplete sample can alter the reported volume and total sperm number.
If home collection is permitted, follow the laboratory’s time and temperature requirements and record the collection time.
List prescription medicines, non-prescription products, supplements, testosterone or anabolic steroid use for the clinician reviewing the result.
What happens if the first result is abnormal?
One abnormal result does not establish infertility. NICE guideline NG257 recommends a repeat confirmatory semen analysis. The repeat is ideally performed about three months later, although azoospermia or a severe sperm deficiency should be checked sooner.
When two or more semen analyses are abnormal, NICE recommends examination of the scrotum and testes and consideration of serum testosterone and gonadotrophin testing. Genetic tests or imaging are targeted to the history, examination and severity of the semen abnormality; they are not automatic for every patient.
Which tests are not routinely needed?
NICE does not recommend routine antisperm antibody testing and, in its 2026 fertility guideline, advises against sperm DNA fragmentation testing in the standard investigation pathway. International guidance can differ in selected clinical situations, so any additional test should have a clear reason and should be interpreted by a clinician experienced in male reproductive health.
If you are taking testosterone or considering treatment, discuss future fertility first. The EAU Sexual and Reproductive Health guidance advises against testosterone therapy for men wishing to father children because it can suppress sperm production.
Six practical FAQs
1. How long should I abstain before semen analysis?
Use the interval specified by the laboratory that will process your sample. If collection occurs outside that interval, tell the laboratory so the result can be interpreted correctly.
2. Can I collect the sample at home?
Some laboratories permit home collection and others prefer on-site production. Ask before the appointment, use the supplied container and follow the stated delivery time and temperature instructions.
3. What if part of the sample is missed?
Tell the laboratory. A complete sample is important because missing a portion can change semen volume and total sperm numbers. The laboratory or clinician can advise whether the test should be repeated.
4. Does one abnormal result mean I am infertile?
No. Semen parameters vary, and no single value proves fertility or infertility. NICE recommends a confirmatory repeat when the first result is abnormal, with timing guided by the severity of the finding.
5. Will I need hormone, genetic or ultrasound tests?
Not everyone does. Further tests are selected after the history, examination and repeat semen results. Hormone testing is often considered after repeated abnormalities; genetic testing is reserved for defined findings such as azoospermia or very low sperm concentrations.
6. Can testosterone treatment affect fertility?
Yes. External testosterone can suppress the hormonal signals needed for sperm production. Tell the clinician if you use prescribed testosterone or anabolic steroids, and do not stop prescribed treatment without medical advice.
What to bring to a London fertility consultation
Previous semen analysis reports and the collection details recorded by the laboratory.
A list of medicines, supplements, testosterone or anabolic steroids.
Relevant medical history, including childhood testicular problems, infections, operations and cancer treatment.
Information about how long you and your partner have been trying to conceive.
Questions about fertility preservation, repeat testing and the next diagnostic step.
For a broader overview, read Male Fertility Tests in London: Semen Analysis, Hormones and What Results Mean and How to Know if a Man Is Fertile: Signs, Tests and When to Seek Help.
Arrange an assessment
If you are concerned about fertility or have an abnormal semen result, a consultation can review the result in the context of your history, examination and reproductive goals. This page provides general information and does not replace an individual medical assessment.
Contact: info@holisticandrology.com
Sources and clinical references
Author
Prof Fabio Castiglione, MD, PhD, FECSM, FEBU
Professor of Urology (Italy); Consultant Urologist and Andrologist, King’s College Hospital NHS Foundation Trust; Honorary Reader, King’s College London; Academic Lead of Urology; GMC No. 7541824; Director and Founder, Holistic Andrology.
Editorial update: 22 October 2026. Clinical review status: awaiting Prof Castiglione’s approval before publication.
EDITORIAL NOTES — REMOVE BEFORE PUBLICATION
Image brief: calm, non-stigmatising editorial illustration of a labelled laboratory sample container, a simplified semen-analysis report and a discreet London location cue. No explicit anatomy, patient photography, microscopes showing identifiable specimens, before-and-after imagery or claims of guaranteed fertility.
Image alt text: Illustration showing preparation and laboratory reporting for semen analysis in London.
Review checklist: confirm clinical wording and local collection instructions; verify current service pathway and fees; upload an original licensed image; remove editorial notes; keep noindex until approval; publish only after written clinical approval.
Entity correction: the automation brief lists GMC 7542824, but the official GMC register returned no result for that number. GMC 7541824 was verified for Fabio Castiglione on 22 October 2026 and is used in this draft.
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