Semen analysis has become a definitive tool for understanding the male
fertility factor. The volume of the ejaculation indicates the functioning and patency of
testicular organs, whereas the quantity and quality of sperm define one’s fertility
profile. Thus, semen analysis is the cornerstone for diagnosis as well as for medical
management. Semen comes with both cellular and non-cellular components. For the
management of male infertility, it is necessary to have better quality sperm. As a result,
semen processing has become an integral part of any medically assisted reproduction.
There are different standardized preparation methods available that include sperm
wash, swim-up technique, pelleting method, density gradient, etc. The aim of this
chapter is to discuss semen analysis, its relevance in understanding male fertility
factors, and the available sperm preparation methods. Based on the literature, it can be
concluded that a proper semen assessment, according to the latest WHO guidelines, is
mandatory for diagnosing male fertility issues. The appropriate sperm preparation
method and good quality of sperms combined with the skill set of embryologists and
environmental conditions will be the decisive factor in any IUI/IVF/ART success.