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Semen Analysis (Spermogram)

This test provides a way to evaluate the concentration, structure and motility of spermatozoa. The semen analysis may result in one of the following diagnoses: astenozoospermy (significant decrease of spermatozoon motility), teratozoospermy (more than half of the spermatozoa have structure abnormalities) and oligozoospermy (very low concentration of spermatozoa). The reproduction specialist will counsel you regarding possible treatment methods. The most common infertility treatment in the cases mentioned above is an artificial insemination procedure using ICSI (injecting spermatozoa into the egg cell). In the laboratory under the microscope the most motile and morphologically appropriate spermatozoa are selected; then those spermatozoa are injected into the egg cell using a thin needle. In rare cases involving very low production of spermatozoa, a testicular biopsy may be performed. Spermatozoa obtained during this biopsy may be used for the ICSI procedure.

Spermogram: what parameters are assessed during the analysis?

Parameters

Norm by WHO standards

Volume

Non less than 2 ml

Color

White, grayish, yellowish

Viscosity/consistence

Dropping, drop up 2 cm

Liquefaction

10 – 40 min

pH level

7.2 - 8.0

Concentration

Quantity of spermatozoa in 1ml

More than 20 M

Count

Quantity of spermatozoa in ejaculate

More than 40 M

Motility

Progressive motile – more than 32%

Total count pf motile spermatozoa – more than 40%

Round cell concentration

Cells of spermatogenesis: leucocytes, macrophages, epithelial cells, immature generative cells

Up to 2%

Agglutination

Adhesion of spermatozoa

None

Morphology

Build of spermatozoa

Quantity of normal spermatozoa is more than 4%

MAR-test

Determination of antispermal antibodies for an exception of immunological cause of male infertility

Negative

NB! An analysis is absolutely required to evaluate the degree of male fertility

For ejaculate with normal, motility, morphology, and amount of sperm, the term “normozoospermia” is used.

There are several types of changes in semen analysis: reducing the total amount of sperm (oligozoospermia), impairment of motility (asthenozoospermia), and changes in sperm morphology (teratoozospermia). However, most often encountered in clinical practice is combined pathology, oligoastenoteratozoospermia (OAT), which is the most common cause of male infertility.
About 10-15% of males suffering from infertility have azoospermia – absolute absence of spermatozoon in the ejaculate.

There are three types of azoospermia:

  1. Obstructive (38%), which is related to impaired patency of seminiferous tubule, due to congenital anomalies or, more commonly, the result of infection or injury. 
  2. Ejaculate (2%), which is related to ejaculate disorders.
  3. Non-obstructive, which is related to spermatogenesis violation (60%). The main causes of non-obstructive infertility, are pituitary decease (which leads to hormonal deficiency), genetic abnormalities, Varicocele, Cryptorchidism, trauma, tumor, testicular torsion, testicular inflammation (Parotitis), effects from drugs and harmful environmental factors.

Other changes in spermogramm:

  1. Necrozoospermia – no live spermatozoa in semen
  2. Cryptozoospermia – occasional spermatozoon in semen
  3. Pyospermia – increased amount of leucocytes in semen due to the inflammatory process. Additional microbiological testing of ejaculate (seeding) may be required to determine the cause of inflammation and choose adequate therapy.

Spermogram: how to prepare for semen analysis?

It is very important to prepare for the semen analysis correctly for the most clear and adequate research of the ejaculate and for the right interpretation of the results to make the diagnosis and to choose necessary medical treatment.

Main rules that must be followed before the semen analysis:

  • Before the semen analysis, you should abstain from sexual activity minimum for 3 days, but no more than 7 days. Sex the day before analysis may lead to a decrease of volume and number of sperm in ejaculate. More than seven days abstinence before the semen analysis can lead to the death of the mature sperm cells, which are capable to fertilization.
  • You should abstain from the use of alcohol or any other drugs (including “Spice”, marijuana) in any form in order to avoid sperm motility decreasing, changing of their form and even death.
  • It is recommended to abstain from strong black tea, coffee and smoking the day before the test to improve the indicators of the ejaculate.
  • It is recommended to exclude fat, fried food that can reduce the total volume of the ejaculate and sperm motility. To improve sperm parameters it is useful to use plant foods rich in vitamins and fiber (fruits and vegetables), protein (lean meat, beef, chicken, rabbit), dairy products. Also, to improve the process of sperm maturation in the testes it is important to use enough vitamins (especially vitamin C and zinc).
  • Total hyperthermia negatively affects the development of sperm, because the optimal temperature for it maturation should be 1-2 degrees lower than normal body temperature (34-350 C). So it is not recommended to attend bath and take a hot bath the day before the sperm test.

It is not recommended to make the sperm analysis:

  • if you have colds and acute respiratory viral infections with fever;
  • in the presence of inflammatory processes in the organs of the urogenital system (urethritis, prostatitis);
  • if you have infections and sexually transmitted diseases (STDs). Infections, such as brucellosis, gonorrhea, influenza, mumps, syphilis, tuberculosis and typhoid, can cause the testicles to atrophy and result in low sperm motility and low sperm count. STDs, such as chlamydia and gonorrhea, can block the epididymis tubes, which leads to infertility.
  • while taking antibiotics or antidepressants;
  • when using anabolic steroids, which can lead to disruption of hormonal functions required for sperm production.

In all the above described cases, you need to make semen analysis not earlier than 1-2 weeks after recovery in order to normalize the clinical and laboratory parameters for the complete removal of drugs from the body.

It is also recommended to limit excessive and prolonged physical activity before the analysis, as the overwork of the body, the accumulation of lactic acid in the muscles and a decline of testosterone level can cause poor semen parameters.

Stresses, lack of sleep and emotional overload can cause hormonal background disorders of the patient due to the increase of impulsation in the nervous system.

It is recommended to make the semen analysis directly in the clinic for the reliability of research in order to avoid false worsening due to various physical factors during transportation.

For the most accurate results, it is recommended to make two researches of semen with an interval of three weeks. If the results of these analyzes are significantly different, you should make a third, additional semen analysis.

You need to read carefully the instruction to the end before the analysis and to follow it strictly.

If the material is obtained out of clinic, it should be delivered for one hour, keeping the temperature conditions (20-400 C) and must not be cooled below 100 C.

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