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.
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