- What is a spermiogram?
- Spermiogram: Procedure
- Spermogram evaluation in the laboratory
- Bad spermogram - what now?
- Improve spermiogram
On spermiogram (Spermauntersuchung) provides information about the quality of the male sperm and thus the fertility of the man. Especially in the case of unfulfilled desire for children, the spermiogram evaluation is an important diagnostic tool to get to the root of the causes. Learn how to create a spermogram and how to interpret the results.
What is a spermiogram?
If a couple tries to have children for a long time in vain, it can be for a variety of reasons. Especially the sperm count and quality is crucial, whether it works with the conception or not. To make a statement about it, a specialist creates a spermiogram. Another reason for a sperm examination is to check if a vasectomy (sterilization of the man) was successful.
The spermiogram evaluation provides information on the number, shape and motility of sperm in the ejaculate (semen). In addition, one can also determine the pH, sugar value, viscosity and bacterial colonization of seminal fluid.
If a man wants to have a spermiogram made, he is looking for a urologist, andrologist (the male counterpart of the gynecologist) or a fertility clinic / fertility clinic. There, the sperm examination is carried out in our own laboratory or passed on to a corresponding laboratory.
Most of the sperm is obtained by masturbation at the site of the investigation. As a rule, a quiet room is available for this purpose. For some men it is helpful if the partner helps with semen collection.
Some doctors also allow the sperm sample to be generated at home. However, there is a higher risk that mishandling of the sample will affect the quality. It is important, for example, that no lubricant is used in the recovery because it reduces the motility of the sperm and, if possible, the entire ejaculate must be absorbed. Subsequently, the sample must be transported in a sterile container at body temperature, for example in the back pocket. And: The sample should reach the lab for a maximum of one hour after extraction.
In addition to masturbation, there is also the possibility to catch the sperm with the help of a condom during sexual intercourse. But a sterile, spermicide and lubricant-free special condom must be used.
In order for the spermiogram values to be meaningful, no ejaculation may occur for at least three to five days prior to the sperm sample being dispensed. Similarly, the spermiogram result may be falsified if the man was abstinent for more than seven days.
Spermogram evaluation in the laboratory
The actual evaluation takes place in the laboratory. There, the relevant parameters are determined, including volume, appearance, consistency and pH. Healthy semen, for example, becomes fluid within a few minutes at room temperature and assumes a milky, gray-opal color.
The sperm itself is examined more closely under the microscope, its form, activity and number examined. In addition, it is also possible to search for inflammatory factors and perform an immunological examination and fructose measurement of the sperm fluid.
Spermiogram: WHO guidelines
When evaluating the sperm sample, the laboratories comply with World Health Organization (WHO) guidelines. For example, the semen WHO guideline states that males are considered fertile if the concentration of sperm cells is at least 15 million sperm per milliliter of ejaculate. If the number is below, one speaks of an oligozoospermia. In some non-surgically sterilized men are in the ejaculate even no sperm to find, the so-called azoospermia.
Other standard spermiogram values used as reference values are:
- 58 percent of sperm vital (live)
- Ejaculate volume at least 1.5 milliliters
- pH between 7 and 8
- Total sperm count in ejaculate at least 39 million
- maximum 1 million white blood cells per milliliter
- at least 13 μmol fructose in the ejaculate (important source of energy for the sperm)
Spermiogram: morphology and motility
In addition to the number of sperm cells, their quality is also decisive. Because the sperm must be able to reach the egg swimming. This is not possible if they are impaired in their function, for example because they are deformed or poorly movable. That would result in a bad spermogram.
In the sperm morphology, three different areas are examined: the head, the middle and the tail. Deviations may occur in all three areas. For example, multiple tails can be created or the head containing the genetic information may be too small or too large. In fact, most sperm are not normally shaped, so according to the WHO, four percent of well-formed cells reach the normal level.
In addition, one evaluates the motility of the sperm in the spermiogram. Basically, a distinction is made here:
a) fast forward movement (fast progressive)
b) slow forward movement (progressive)
c) swim in a circle or only locally (not progressive)
d) do not move (immotile)
The reference values here are that a total of 40 percent of all sperm (overall motility) and once again one third (32 percent) should move progressively, ie purposefully.
Another criterion for sperm quality is the so-called MAR (Mixed Antiglobulin Reaction Test) test. For the ejaculate is examined for sperm autoantibodies. These antibodies arise, for example, when the vas deferens are injured inside. They stick to the sperm and cause them to swim worse through the womb mucus. As a guideline, therefore, that not more than 50 percent of sperm cells may carry such particles.
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Bad spermogram - what now?
The reasons for a bad spermiogram can be manifold. For example, previous or active infections (mumps, chlamydia), undescended testes, endocrine disruptors or even genetic preloads play a role. Sometimes the causes remain unclear. In the same way, however, it may also have been incorrectly due to errors in handling (such as the extraction at home).
It is generally recommended to repeat the spermogram after a few weeks if findings are outside the normal spermiogram range. If the values still deviate, further diagnostic methods are used to find the cause of the bad spermiogram.
There are several ways that the spermiogram can improve. An important starting point is the lifestyle, for example quit smoking, to lose weight in overweight or to consume alcohol only in moderation. In some cases, hormone treatments or surgery helps. If these attempts are not fruitful, this does not mean that the desire to have a baby must be buried. Medicine has some alternatives for artificial insemination.
Finally, the spermogram evaluation is a snapshot and will not always tell you clearly if a man is fertile or not. Nevertheless, that is spermiogram an important element of diagnostics in case of unfulfilled desire for children.