Spermogram

In the onset of pregnancy, two are always involved: a woman and a man. A couple is considered infertile if pregnancy does not occur within a year of regular unprotected sex. Did you know that in almost half of cases, the cause of infertility is the inability of sperm to fertilize an egg, that is, male infertility? It is advisable to start the examination of an infertile couple with a spermogram.

A spermogram is a screening study of sperm (ejaculate) that allows you to assess the fertilizing ability of a man (fertility) and to identify diseases of the male genital area. In fact, the ejaculate is a mixture of secretions of the male sex glands (testicles, their appendages, prostate, paraurethral glands), so the study suggests pathology at different levels of the reproductive system.

Who needs a semen analysis in the first place?
Men in infertile couples
If a couple is planning a pregnancy (competent approach)
As part of a comprehensive examination before using IVF and other assistive technologies
Future sperm donors
What indicators are assessed in the semen analysis?
First, the physical and chemical properties of the ejaculate are assessed: color, specific odor, volume, semen viscosity, ph balance, amount of mucus.

Next, the number and mobility of sperm, the number of leukocytes and the presence of erythrocytes are determined; the structure of cells is studied and active and motile spermatozoa (normal), as well as pathological and immature cells are counted.

How to understand that the spermogram is normal?
When the result is obtained, the standard values ​​set by the World Health Organization (WHO) are displayed in front of each indicator. It is good if the indicators do not go beyond the limits, and in the conclusion it says “normozoospermia”. This means that the total number, the percentage of spermatozoa capable of penetrating the egg (progressively motile), and morphologically normal cells are normal.

What are the possible deviations in the spermogram?
The changes are assessed by the physician in the aggregate and in comparison with other studies. Here’s what the doctor pays attention to:

If the semen is very viscous, does not liquefy for a long time or does not liquefy at all, inflammation of the prostate gland should be excluded
The volume of ejaculate less than 1 ml (subject to the rules of preparation) may indicate a lack of androgens, endocrine disorders, problems with the testicles and vas deferens
When sperm agglutinate, they clump together (heads, tails, or heads with tails), which reduces the likelihood of fertilization. During aggregation, motile spermatozoa stick together with other cells or mucus, which happens with inflammation or genital infections.
A large number of leukocytes (more than 106 / ml) indicates the presence of an infection, which often leads to impaired sperm motility
The appearance of immature germ cells in the ejaculate – requires the exclusion of testicular pathology
Changes in sperm count, impaired motility and the appearance of defects (head, neck or tail) are indicated by the following terms, which usually frighten the patient:

When there are few sperm – oligozoospermia
Few motile sperm (below normal) – asthenozoospermia
A decrease in cells with a normal structure and an increase in sperm with defects – teratozoospermia
There are no sperm in the ejaculate – azoospermia

Fecundation

There may be a combination of features (eg, oligoasthenoteratozoospermia)
Once again, I draw your attention to the fact that the urologist or andrologist is engaged in decoding the spermogram, taking into account all the subtleties and nuances. On the basis of deviations in a single study, the diagnosis is not made. The doctor prescribes repeated studies at least 3 times at regular intervals in order to exclude non-compliance with the conditions at the preparation stage and to form a complete picture of the disease.

How to properly prepare for a spermogram?
It is necessary to call the medical office convenient for you in advance and make an appointment for the study!

To obtain an adequate result, you must:

refrain from intercourse for 2-7 days (the optimal period is 3-4 days). During this period, exclude alcohol, heavy physical activity, visiting saunas and baths, other thermal procedures, and taking medications.
On the day of the study, carry out hygiene procedures and collect the semen in a sterile container by masturbation in the medical office of the laboratory (preferably) or at home. You cannot use a condom because the chemicals in its composition interfere with sperm motility. It is important to collect the full volume of ejaculate!
It is allowed to collect semen at home if you can ensure delivery within an hour at temperatures from +20 to + 35 degrees. We recommend using the thermos after rinsing with warm (not hot!) Water.
Spermogram is a screening test. If the doctor is convinced of the presence of abnormalities, additional tests are prescribed: hormone levels, MAR test (often prescribed simultaneously with a spermogram), fragmentation of sperm DNA; as well as instrumental methods.

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