Sperm count test (semen clinical analysis)

Spermogram is necessary to asses men’s fertility levels. Semen analysis is recommended to check the quality of the man’s sperm. If after a year without any contraception pregnancy has not occurred, one of the recommended initial tests for the couple will be semen analysis to check the overall quality of the sperm.

Spermogram: what parameters are studied in the analysis?

Volume: the volume of ejaculate in millilitres

Viscosity: determines thickness or consistency of the sperm.

Liquefaction time: how long it takes before semen becomes liquid.

Agglutination: a microscopic examination to detect clumping that may hinder sperm motility.

pH: quality semen pH is alkaline and protects the sperm from female vaginal discharge, which has acidic pH.

Sperm concentration: quantity of sperm in 1 ml of ejaculate.

Sperm motility: percentage of sperm with intensive progressive motility.

Sperm morphology: percentage of normally shaped sperm. Sperm head contains genetic information, so it is very important for it to have the right shape.

IgG MAR test (agglutination reaction test): detects presence of antisperm antibodies on the sperm surface, which are responsible for immune response of the body to its sperm.

In the event of ICSI, if necessary, the HBA test is done to select the best and most developed sperm for subsequent egg fertilisation.

Semen analysis (spermogram) itself does not prove infertility, but the obtained results indicate reduced ability of the sperm to fertilise the egg.

Spermogram results may vary, as it is affected by numerous factors, e.g. alcohol, smoking, age, medication, sports activities, etc.

Semen analysis results allow diagnosing the following conditions:

• normospermia (ejaculate with normal quantity, motility and morphology parameters);
• asthenozoospermia (significantly reduced sperm motility);
• teratozoospermia (changes in sperm morphology, more than a half with structural abnormalities);
• oligozoospermia (very low sperm count);
• azoospermia (no sperm in the ejaculate);
• the most common combined condition encountered in clinical practice is oligoasthenoteratozoospermia (OAT), which is considered most common cause of male infertility;
• Azoospermia (zero sperm in the ejaculate) is observed in 10-15% of men with infertility.

Azoospermia types:

• Obstructive, reproductive tract for the testicles is blocked due to a hereditary condition or, more commonly, as a result of an infection or a trauma.
• Non-obstructive, due to impaired spermatogenesis. Among the root causes of non-obstructive infertility are pituitary conditions (hormonal deficiency), genetic abnormalities, varicocele, cryptorchidism, traumas, tumours, testicular torsion, inflammation of the testicles (mumps), adverse effects of drugs and harmful environmental effects.

In such event, andrologist or fertility specialist will explain available treatment options to you. The most common infertility treatment in such circumstances is artificial insemination procedure using ICSI (intracytoplasmic sperm injection). In a lab, the most motile and morphologically (and structurally) correct sperm are selected under the microscope and then used for fertilisation by injecting inside the egg using a thin needle. In rare cases, when semen production is impaired, the sperm is retrieved by testicular tissue biopsy. The sperm collected this way can also be used for ICSI.

There other spermogram diagnoses:

• Necrospermia, when there are no live sperm in the ejaculate.
• Cryptospermia, when only individual motile sperm are present in the ejaculate.
• Pyospermia, high number of white blood cells due to inflammation. It may require additional microbiological examinations (cultures) of the ejaculate to identify the cause of the inflammation and prescribe necessary treatment.

Spermogram: how to prepare for testing?

Correct preparation for collecting a semen sample is very important to ensure precise and adequate examination of the ejaculate and interpretation of results. Diagnosis and selection of treatment also depend on it.

Basic rules before collecting a semen sample:

• Abstain from sex for at least three days, but no longer than one week before the test. Intimate contacts before collecting the sample may reduce the amount of the ejaculate and amount of sperm in it. Abstinence for more than seven days before the test may lead of matured sperm death.
• Abstain from alcohol or narcotics (include spice and marijuana) in any form to avoid sperm motility reduction, change of shape of even death.
• For better result, do not drinking strong black tea or coffee and do not smoke one day before the test.
• It is advisable not to eat any fatty or fried foods that may reduce the ejaculate amount and sperm motility. For better result, choose healthy food rich in vitamins and fibres (fruits and vegetables), proteins (lean meat, beef, chicken, rabbit), dairy products. Sufficient amount of vitamins (especially vitamin C and zinc) in the diet is also important for better sperm maturity.
• Body overheating adversely affects sperm production, as the optimum temperature for sperm maturity should be 1-2°C lower than normal body temperature (34-35°C). That is why it is not advisable to visit sauna or take a hot bath one day before the test.

Taking the test is not recommended:

• in case of a cold or acute respiratory infection with fever;
• in case of any inflammation of urogenital organs (urethritis, prostatitis);
• in case of an infection or a sexually transmitted disease (brucellosis, gonorrhoea, flue, mumps, syphilis, tuberculosis, fever), which may lead to testicular atrophy, sperm motility disorders and sperm depletion. Sexually transmitted disease, i.e. chlamydia and gonorrhoea, may result in blockage of the epididymis leading to infertility;
• if using antibiotics or antidepressants;
• if using anabolic steroids, which may cause hormonal disorders.

In all aforementioned situation, the sperm should be collected at least 1-2 week after recovering, to allow your lab parameters to return to normal levels and for medication clearance.

It is advisable to avoid strenuous and prolonged physical exertion one day before the test, as body overload, lactic acid build-up in the muscles and drop of testosterone levels may affect your sperm performance.

Stress, lack of sleep and emotional overload may cause hormonal imbalance.

For more accurate testing, we recommend collecting the sample directly at the clinic to avoid sperm parameter deterioration due to various physical factors during its transportation.

To obtain the most accurate result, we recommend doing two sperm tests with a 3-week interval. If test results significantly differ, a an additional third test is done.

Make sure you read and strictly follow all instructions before collecting the sperm.

If the material has been collected outside the clinic, it should be delivered within one hour ensuring the required temperature range (20-40°C). Under no circumstances the sample can be cooled below 10°С.