The first and foremost factor in male infertility testing is spermogram. Before carrying out the examination you need to know the following information:
- Before testing the semen, it is recommended to abstain from sexual intercourse for three days;
- The semen is collected in a clean container through masturbation (at a medical office or at home). If it happens at home, the sperm must be delivered to the laboratory within an hour and the container should be held to the skin to keep it at body temperature. It is not desirable to collect semen during coitus in a condom;
- Spermogram may vary even for a healthy man depending on lifestyle (it is affected by bathing, alcohol, intense sport, illness) within the last 3 months;
- If the first spermogram shows abnormalities, it should be repeated a second time after 4-8 weeks.
Sperm types and diagnosis:
- normospermia – all characteristics correspond to normal values;
- oligospermia – sperm concentration of less than 20 million/ml;
- asthenospermia – less than 50% of spermatozoa are capable of moving forward;
- teratospermia – less than 30% of spermatozoa with normal morphology;
- oligoasthenoteratospermia – motility, count and morphology disorder;
- azoospermia – ejaculate contains no sperm;
- aspermia – no ejaculate.
| Parameter | Reference interval | Possible cause |
| Volume | 1.5–5.0 ml (pH 7.2–7.8) | Too little material – ejaculatory dysfunction, hypogonadism, improperly collected material
Acidic conditions – vas deferens obstruction or congenital abnormalities |
| Concentration | > 20 million/ml | Azoospermia or oligospermia – varicocele, a genetic pathology, cryptorchidism, endocrinopathy, medication, infection, toxins or radiological impact, obstruction, idiopathic |
| Total motility | > 10 million | |
| Motility | A + B > 35 % (50 %) | Asthenozoospermia – prolonged abstinence, antispermal antibodies, partial obstruction, infection, idiopathic |
| Morphology | > 4 % | Teratospermia – varicocele, a genetic pathology, cryptorchidism, endocrinopathy, medication, infection, toxins or radiological impact, obstruction, idiopathic |
| Antispermal antibodies | ≥ 20 % | Ductal obstruction, testicular trauma, infection, vasovasostomy or vasoepididymostomy (50-70% incidence) |
| Presence of other cells | Semen also contains other cells, including sperm predecessors – spermatids and epithelial cells from the vas deferens and urethra. During inflammation, white blood cells and sometimes red blood cells (more common in a severe inflammation or after testicular injuries) can be found |
