Interpretation of spermograms: indicators of norms and deviations

The calculator is designed to analyze the results of spermograms and estimate the number of spermatozoa capable of fertilization.

In a healthy male ejaculate, the number of fertilizable sperm (i.e., viable, motile, normal forms) must be at least 15-30 million. The same requirements apply to potential donors. However, a natural pregnancy can be hoped for at lower rates.

Until 1999, it was considered to be a man capable of conception, if the total number of sperm was more than 40 million, of which motile - more than 50%, viable - more than 50%, with normal morphology - more than 15%. Thus, it was believed that a successful conception requires at least 3 million fertilizable sperm.

According to the latest WHO standards of 2010, pregnancy can occur naturally if the total number of spermatozoa is not less than 39 million, of which motile is more than 40%, viable is more than 58%, with normal morphology not less than 4%. That is, the number of spermatozoa capable of fertilization should be at least 500-625 thousand.

WHO 2010WHO 1999
Volume of ejaculate1.5 ml≥ 2 ml
Liquefaction time6≥ 20×10 6
Total sperm count39×10 6≥ 40×10 6
Living58%≥ 75%
Morphology (normal forms)4%≥ 14%
Movable (a + b)40%≥ 50%
Actively moving (a)32%≥ 25%
White blood cells6 / ml6 / ml
MAR-test> 624 200

What does spermogram show and what parameters are evaluated?

The results of such a study may vary, depending on how thorough the preparation was. Only an experienced specialist should decipher the results; you yourself can only become familiar with the norm and determine deviations from it. However, in any case, the results of decoding spermograms and the appointment of adequate treatment tactics is the task of the doctor.

In this study, a large number of factors will be evaluated. These include:

  • ejaculate liquefaction time
  • semen volume
  • sperm color
  • sperm count
  • germ cell motility
  • bonding of sperm,
  • the presence of antibodies to sperm.

Decoding the results of sperm analysis should contain information about each item, which will make it as reliable as possible. To understand why each parameter is assessed, it is worth exploring each of them in more detail.

Normally, semen is not completely liquid, but this parameter is necessarily taken into account when analyzing spermograms. Seminal fluid begins to liquefy through time under the influence of prostate enzymes. There is no direct relationship between the ejaculate liquefaction time and male infertility, but the liquefaction time may indicate problems.

Also, the sperm morphology necessarily takes into account the amount of ejaculate released. This is due to the fact that, getting into the vagina of a woman, the sperm cells are exposed to aggressive effects of the acidic environment. The task of sperm is to temporarily alkalize it, so that the strongest sperm can get into the uterus. Lack of ejaculate will not allow the germ cells to cope with this task.

Also taken into account is the color of seminal fluid. Previously, this parameter has received much attention, but it does not carry almost any information, as evidenced by WHO research. The exception is when seminal fluid has uncharacteristic shades.

One of the most important indicators of sperm - the number and mobility of sperm in one milliliter of seminal fluid. The presence or absence of problems with the male reproductive system will depend on these parameters. Insufficient mobility and the number of cells will not allow pregnancy to occur.

If the decoding of the MAP test and spermogram indicates that germ cells are glued together, this can be a sign of serious impairment of the immune system. Sperm cells are glued together if antibodies to them are present.

Similarly, the decoding of the MAP test and spermograms may indicate that antibodies are produced in the body, which leads to the fact that immunoglobulins completely or partially block the germ cells, even though they are produced in the proper amount and have sufficient mobility.

What should be the semen rate and what standards apply?

In the Russian Federation there are no standards approved at the federal level and mandatory for all medical institutions that provide laboratory research services. The rate of spermograms in each clinic is different, and on the basis of these requirements, the procedure for the delivery of seminal fluid and the evaluation of its performance is regulated. Because of this, the norms may differ significantly, as well as the interpretation of the data obtained from the results of the study.

To date, a specific guideline is the recommendations of the WHO, which is engaged in the constant study of reference values ​​for semen, and revises the results. Today, the norms that are enshrined in the fifth edition of the World Health Organization in 2010 are considered to be in force.

However, you need to understand that, for example, the normal Kruger sperm profile morphology in each clinic will be different, since not every institution is guided by the recommendations given.

The center of reproduction "Genesis" takes into account the norm prescribed in the WHO publication, thanks to which we estimate the seminal fluid values ​​of each patient as objectively as possible. The rate of semen for conception is as follows:

  • the volume of ejaculate should be between 1.5 ml and more,
  • the consistency must be viscous,
  • dilution occurs in 10-60 minutes,
  • viscosity - up to 2 centimeters,
  • the peculiar smell of spermine is considered normal,
  • normal spermogram shows ejaculate color from white to grayish,
  • pH should be between 7.2 and 8.0,
  • semen should be turbid,
  • mucus should not be
  • the number of germ cells per 1 ml - from 15 million and more,
  • total amount - from 39 million and more
  • there should be no aggregation and agglutination of sperm,
  • leukocytes should not exceed 1 million per 1 ml of ejaculate; red blood cells, Neisseriagonorrhoeae and Trichomonasvaginalis should be absent.

In addition, an indicator of the sperm rate is considered to be the presence of more than 32% of progressively motile sperm in the ejaculate. Viability is determined by bloom staining, it should be at least 58%. Immature spermatozoa should be no more than 2%, spermatogenesis cells should be no more than 4 per hundred spermatozoa, and normal forms should be 4% or more. Normal sperm values ​​suggest the presence of a small number of residual bodies.

Deviations in semen

Sometimes the results of the analysis show that red blood cells are present or leukocytes are elevated in the spermogram, and there are other deviations. The reason may lie in a variety of factors, which include inflammation, infection, anatomical disorders, and much more. Often in decoding you can see the various words that characterize certain states. It should be familiar with them for a better understanding of the situation.

Erythrocytes, leukocytes, other deviations in the spermogram

A person who first encounters the procedure for collecting sperm for research, it is difficult to navigate in the names. Each state has its own name, due to which doctors are oriented in deciphering the tests and can make a diagnosis. For example, agglutination in the semen means that the sperm stick together, which prevents them from getting to the egg.

There are also other names of pathological conditions:

  • oligospermia - the amount of sperm is below normal,
  • hematospermia (hemospermia) - red blood cells are detected in the spermogram,
  • aspermia - spermatogenesis cells and spermatozoa are absent in seminal fluid,
  • oligozoospermia - the total number of germ cells is less than that,
  • oligoterozoospermia - the total number of morphologically correct and motile sperm is less than normal,
  • leukospermia (pyospermia) - leukocytes are elevated in the spermogram,
  • oligoasthenozoospermia - the total number and percentage of motile germ cells are reduced,
  • oligoasthenoterozoospermia - the total number, the percentage of motile germ cells of normal morphology are reduced,
  • asthenozoospermia - the number of motile cells is reduced,
  • teratospermia (teratozoospermia) - few normal sperm, defects, abnormalities and head anomalies by spermogram - above normal

The presence of certain factors can be caused by completely different reasons. They may consist in heredity, disruptions in the hormonal background, exposure to x-rays or radiation, lead, mercury or other toxic substances. In addition, the causes of the pathology in which there are elevated leukocytes in the spermogram, or any other, can be infections, inflammation, alcohol abuse or drugs. In the center of reproduction "Genesis" will determine the cause and prescribe adequate treatment.

Causes of poor sperm morphology

The quality of seminal fluid, which is displayed on the spermogram, is influenced by many factors. The reasons may be:

  • inflammation of the reproductive system in a chronic form,
  • infectious diseases, including STDs,
  • Improving the quality of spermograms is possible with the abandonment of alcohol, drugs, tobacco,
  • varicose veins of the testicle and spermatic cord, called "varicocele"
  • tumors and endocrine diseases,
  • underdevelopment or dysfunction of the testes, a small number of Leydig cells,
  • no testicular prolapse in the scrotum,
  • brain diseases, chromosomal pathologies will make you think about how to improve spermogram,
  • hard work, physical exhaustion, stress,
  • intoxication of the body, exposure to radiation, high temperatures,
  • tight diets and fasting, vitamin deficiency,
  • prolonged abstinence from sexual intercourse or too frequent ejaculation.

Learn how to improve the morphology of sperm, you need in each of these cases. There are two options: cure the underlying disease or stimulate spermatogenesis. If everything is clear with the cure of the underlying disease, then stimulation is aimed at maximally improving the test results and obtaining a biomaterial that can be used for IVF, insemination or freezing.

How to improve spermogram?

Spouses who get poor semen readings often think about how to improve the husband sperm morphology. Deviations in such an analysis are not uncommon in the modern world, which is associated with poor ecology, high levels of stress and other unfavorable factors, for example, flaws in diet, alcohol, tobacco, drugs, as well as ignoring planned physicians and self-medication. This is especially true of residents of large cities with polluted air and people with hard work. There are several options through which you can improve the situation.

They are aimed at improving the patient's lifestyle. Spermatozoa ripen for about 75 days. Give up bad habits or significantly reduce the amount of alcohol and tobacco consumed.

It is important to balance the diet, include fish, meat and liver, and seafood. Eggs, dairy products, fruits and dried fruits, greens will be useful. It is important not to overeat, but also not to starve and abandon strict diets.

It is also best to have regular sex life - having sex once every 2-3 days, more rare sex acts will reduce sperm motility, and more frequent will not allow them to mature.

You will need to refuse to visit the sauna and bath, and not to wear tight underwear. It is important to treat diseases in time, to prevent their transition to the chronic form. Stress and overwork at work also adversely affect semen performance. Before attempting to conceive, it is best to refuse to take medication, and if this is not possible, it is worth warning the attending physician about it.

Knowing the causes of bad semen and what affects the quality of seminal fluid, you can eliminate the negative factors and achieve pregnancy. Experienced professionals will help you at the Genesis Reproduction Center; they have helped more than a couple of couples to become happy parents. We will show you how to improve the quality of spermogram for conception and what to pay special attention to.

Sperm count

normozoospermia - normal semen reading
butzoospermia - the absence of sperm in the ejaculate (after centrifugation)
necrozoospermia - an increase in the number of dead or immobile spermatozoa
teratozoospermia - increase in the number of pathological spermatozoa
asthenozoospermia - reduced motile sperm count
asthenoteratozoospermia - decrease in the number of motile spermatozoa, an increase in the number of pathological spermatozoa
oligozoospermia - reducing the number of sperm in the ejaculate
oligoteratozoospermia - reducing the number of sperm in the ejaculate, increasing the number of pathological sperm
oligoastenozoospermia - reducing the number of sperm in the ejaculate, reducing the number of motile sperm
oligoasthenoteratozoospermia - reducing the number of sperm in the ejaculate, reducing the number of motile spermatozoa, increasing the number of pathological spermatozoa
cryptozoospermia - a critically small amount of sperm in the ejaculate (after centrifugation)
cryptoteratozoospermia - a critically small number of spermatozoa in the ejaculate (after centrifugation), an increase in the number of pathological spermatozoa
cryptoastenozoospermia - a critically small number of spermatozoa in the ejaculate (after centrifugation), a decrease in the number of motile spermatozoa
cryptoastenoteratozoospermia - a critically small number of spermatozoa in the ejaculate (after centrifugation), a decrease in the number of motile spermatozoa, an increase in the number of pathological spermatozoa
polyzoospermia - increased sperm count in the ejaculate (> 250000000 / ml)

Hello, with such a sperm possible conception?
Abstinence 3 days. (02.18.2015) (WHO Standard Laboratory 2010)
Color: milky gray
Viscosity: 0 (0-3)
pH: 7.3 (7.2 or more)
Agglutination: 0 (0-4)
Volume: 1 ml (1.5 ml and more)
Liquefaction time: 30 minutes (up to 60 min)
Sper.-s: in 1 ml: 59 million (15 million and more)
Number of sperm per ejaculate: 59 million (39 million or more)
Number of other (round) cells: 2.36 million / ml (less than 5 million / ml)
Sperm motility (%)
Forward Movement (PR): 43% (32 or more)
On-the-spot (NP): 4%
Fixed (IM): 53%
Total mobility (PR + NP): 47% (40 or more)
Note aggregation +
MORPHOLOGY by Kruger-Menkveid strict criteria
Normal: 3% (4 or more)
Pathology:
head and neck: 97%
Middle section: 20%
Tail: 6%
Leukocytes: less than 1 million / ml
Spermatogenesis cells: less than 4 million / ml
MAR test
igG: 0% (less than 50%)
IgA (if positive IgG> 10%: 0 (alex says:

Made spermogram, there: transparent, time of liquefaction 1 min., The number of sperm in 1 ml-9 million, a total of 46 million, active-mobile 18, slow 26%, live 68%, dead 32%, normal morphology 47% and pathological-53%. , beteher crystals +, leukocyte 0-2. What is the percentage of pregnancy in a natural way?

Having experienced and tested a lot I can say that the surest way to improve the quality of sperm is sports, diet and proper nutrition. And the doctor recommended her husband profertil as an active supplement that affects the quality of sperm. It helped us a lot to conceive a child.

Hello! decipher please semen, thank you in advance
IDA test: negative
Volume: 3.0 ml
Color: yellowish green
Smell: Specif
Viscosity: 0.2 cm
Dilution: 60 min
Amount per million 1ml: 29 million
Total count: 87 million
Class A% mobility: 20%
mobility class B%: 32%
mobility class С%: 42%
mobility class D%: 6%
A + B + C,% (viability): 94%
Agglutination: (+) -
Aggregation: (++) -
Leukocytes: 10-12 in p / zr
Epithel. cells: 0-1 in p / zr
Macrophages: 0-1 -
Lecithin grain: (++) -
Beethera crystals: none -
Amyloid bodies: none
Normal form: 85%
Tail pathology: 3%
Young: 5%
Pathology of the head: 2%
Turbidity: Muddy -

85% of normal sperm is highly questionable. The occurrence of pregnancy in a natural way is possible with 4% of normal sperm. But to draw conclusions about fertility based only on the morphology of sperm. wrongly. Important and such indicators ejaculate concentration, volume, mobility (a + b). The fertility index is calculated and if it is equal to or higher than 0.5-0.6, then conception by natural means is possible within a year. WHO data on human ejaculate research fifth edition.

Help pozh. decipher semen analysis: Volume - 2.6 ml., pH - 8, watering - 1, round cells - 2, motile sperm in 1 ml. - 7, fixed in 1 ml. - 16,

Why do you need semen?

Modern medicine has learned to deeply analyze sperm on many criteria, this will be discussed below. This approach contributes to the rapid detection of abnormalities and contributes to the rapid and accurate treatment to restore fertile function.

The main indicators in the analysis and interpretation of semen are total sperm motility and the number of living, however, there are still about 10-15 parameters that can affect the ability to conceive a child.

Preparation for the delivery of sperm for analysis

To obtain accurate analyzes, indicating the real possibilities of the male fertile function, criteria have been developed preparation for the delivery of semen.

Mandatory training points include:

  • Sexual abstinence for 3-5 daysit is not recommended to even get excited
  • Exclude general overheating organism and in particular the inguinal region in 1-2 weeks before putting on spermogram. Banned hot baths, baths, saunas, showers should be taken warm, not hot.
  • Give up alcoholic beverages within 1-2 weeks prior to analysis.
  • Get enough sleepto eliminate heavy physical exertion

In general, during this period it is recommended to switch to a more healthy lifestyle, eliminate or reduce smoking, eat healthier foods, excluding food with preservatives, exercise regularly, while eliminating heavy loads (gymnastics and weight training will be best).

Sometimes, having received any deviations, it is enough just to take a more responsible approach to preparing for the analysis, and the spermogram will show a good result. Do not forget that when trying to conceive a baby, you need to go through the same period of preparation to the maximum sperm quality.

How to pass sperm for analysis?

The most accurate and affordable method of delivering spermogram is to receive it by masturbation method, usually ejaculation takes place in a special room in the laboratory. At the same time, to minimize all kinds of impurities, it should be done with clean, washed hands. If there is a psychological barrier, it is possible to get sperm for analysis by incomplete sexual intercourse in a special condom, but this can be done only at home.

As a rule, sperm should be donated directly to the clinic, as the time after ejaculation is very critical for an accurate analysis. If the material is prepared at home, it is necessary to deliver the liquid to the laboratory within an hour at a temperature not lower than +20 degrees Celsius.

To obtain a more accurate conclusion about the state of the reproductive function by decoding the spermogram, it is recommended to perform several tests over several months in order to see changes in the dynamics, eliminating an error or an accident.

How much is spermogram?

Important question how much is the spermogram, especially if you want to take several tests. The cost of such a study usually ranges from 700-1500 rubles, depending on the clinic. It is recommended to conduct simultaneously another MAP test. For this one portion of the obtained seminal fluid is enough. Normally the semen is ready the next day.

Analysis and interpretation of semen, terminology

After the analysis is completed and the spermogram is obtained, it should be decrypted. The first thing you should pay attention to is the conclusion written at the end. This will be the word with the end of the "sperm", which indicates the presence or absence of abnormalities. Based on this, you can say good or bad patient spermogram. The following are the most frequently reported conclusions about the quality of the ejaculate.

  • azoospermia - means that not a single sperm was found in the ejaculate, which indicates the impossibility of conception.
  • akinoseospermia - speaks of absolutely motionless spermatozoa, which excludes the possibility of getting pregnant
  • antisperm antibodies(ASAT / ASA) - the presence of antibodies that the immune system has developed against sperm, considering them to be alien. Depending on the number of such antibodies, it acts as an insignificant factor, and completely excludes the possibility of pregnancy.
  • asthenozoospermia - spermatozoa are generally motile, but this motility is insufficient (the category of motile A is less than 25%, or A + B is less than 50%)
  • hemospermia - the presence of red blood cells in the ejaculate
  • leukocytospermia - increased concentration of leukocytes in seminal fluid
  • necrozoospermia - the absence of live sperm in the ejaculate, says about the impossibility of getting pregnant
  • normozoospermia - The sperm is capable of conceiving a baby, however there are some minor deviations.
  • normospermia - the best and long-awaited diagnosis, meaning the rate of all indicators. Good semen
  • oligozoospermia - means that the concentration of sperm below the lower limit of the norm of 20 million per 1 ml.
  • oligospermia - too low total semen volume, below 1.5-2 ml
  • teratozoospermia - too large percentage of sperm with abnormal abnormalities, more than 50%

Sperm standards and causes of deviations

After reviewing the conclusion, if there are any abnormalities, it will be necessary to decrypt the spermogram. This can be done using the table below which shows normal spermogram indicators, evaluation criteria and possible pathological causes of deviations.

Indicator

Norm

Possible pathological causes of deviation

Total Ejaculate Rating

Liquefaction time, minutes

> 60 minutes: prostatitis, vesiculitis, enzyme deficiency

6 ml: too long period of abstinence, prostatitis, vesiculitis, Cooperite (inflammation of the Cooper glands)

Viscosity index, cm

More than 20 mm: orchitis, epididymitis, prostatitis, varicocele

deviation in any direction: prostatitis, vesiculitis, Cooperite

Ejaculant color (shades)

grayish white, milky, yellowish

Brown: prostatitis, prostate cancer, perineal injury

Reddish: prostatitis, perineal injury, prostate cancer, vesiculitis

Yellow: jaundice or taking multivitamins

The total number of sperm in the ejaculate, million

total absence or not more than 4 in sight

Excess: inflammation of the testes, inflammation of the genital glands, inflammation of the external genital organs

Detected: injury, swelling of the testicle or accessory gonads, inflammation of the testicles and accessory genital glands, inflammation of the urinary canal

Sperm Evaluation

Concentration (amount in 1 ml), million / ml

120 million: increased testosterone, inflammation in the genitourinary system

Indications for the study

It is necessary to pass the ejaculate on semen in the following cases:

A man is simply interested in his reproductive health and wants to be convinced of his ability to become a father,

Pregnancy at the partner does not come within at least one year of regular sexual life without use of contraception,

A man is diagnosed with a disease or congenital pathology, which can lead to infertility (hypogonadism, varicocele, orchitis, urethritis, prostatitis, etc.),

The couple is going to resort to in vitro fertilization or artificial insemination.

Types of semen

There are four main types of this analysis:

Baseline spermogram, the norms of which were fixed by the World Health Organization in 1999,

MAR testdemonstrating the presence or absence of antisperm antibodies in the ejaculate are cells that destroy spermatozoa. They may appear as a result of endocrine or autoimmune disease, as well as due to the biochemical incompatibility of partners,

Morphological analysis sperm according to Kruger, allowing to evaluate the physical indicators of male germ cells - the shape of the head, neck and tail,

Biochemical analysis seminal fluid, which shows the content of enzymes, amino acids, carbohydrates, vitamins and minerals.

The first type of study (basic spermogram) is standard and is assigned to all, and the remaining three are used if the interpretation of the spermogram results shows deviations from the norm.

Preparation and delivery of analysis

It is very important to observe all the nuances in order to get a reliable result:

If a man is undergoing treatment or is using any drugs all the time, this must be reported to your doctor, as some drugs may distort the diagnostic picture. For example, antibiotics need to finish taking no later than two weeks before taking sperm,

Before visiting the laboratory, you should refrain from intimacy for two to five days, ideally three. This refers to any type of sexual activity, including self-gratification, that is, a man should not ejaculate during this entire period. In addition, you can not drink alcohol, go to the bath or sauna. It is unacceptable to go to the clinic in a sick condition, with high fever,

Sperm collection is carried out exclusively in the process of masturbation, interrupted sexual intercourse or oral sex is not suitable for this, because in this case, the ejaculate will contain the biological fluids of the partner. Stimulation should take place without the use of saliva or a special lubricant, this can also distort the results of semen,

For the collection of semen for analysis issued container - a small plastic container with a lid. Some laboratories offer a choice of a special medical condom, devoid of chemicals that affect the composition of seminal fluid. Then the man is invited to go into the room where he can be left alone and masturbate. In private clinics such premises can be properly equipped - a comfortable environment, video, magazines. In state medical institutions you can’t count on it,

It happens that a man can not relax in an unusual environment, is under stress, and therefore it is impossible to pass spermogram directly on the spot. In this case, the container or medical condom can be purchased at a pharmacy, collect the ejaculate at home and deliver the biomaterial to the laboratory. However, this must be done within one hour, while maintaining the natural temperature of the seminal fluid. The easiest thing is to clamp the container in the armpit,

Deciphering the results of spermograms will be available in a few days, sometimes even the next day - it all depends on the internal routine of a particular medical facility. If there are deviations from the norm, there is no need to be upset, because the ejaculate indicators are very changeable and depend on a number of factors. It is recommended that you take the spermogram at least three times at intervals of 10-14 days to be sure that the results of the examination are reliable.

The rate of semen in the table

Total ejaculate volume

Viscous - when lifting drops, threads up to 2 cm high are formed

Total sperm count
in portions of ejaculate

The concentration of sperm in the ejaculate

20-100 million per 1 ml

Motility 1 hour after ejaculation

Type A - more than 25% (active sperm with straight motion)

Types A + B - more than 50% (type B - low-active spermatozoa with straight motion)

Type C - less than 50% (low-active sperm with oscillatory or rotational movement)

Type D - less than 10% (inactive sperm)

The proportion of viable sperm

The proportion of sperm with a normal head morphology

The proportion of spermatogenesis cells

Agglutination and aggregation

Up to 1 million per 1 ml (3-4 per field of view)

Missing or insignificant

Interpretation of the results of semen

Now consider the value of the indicators from the table in more detail:

Overall volume seminal fluid should be at least 2 ml. A decrease in the amount of sperm secreted indicates an insufficient prostate gland activity, retrograde ejaculation (the release of sperm into the bladder), hypogonadism, or an impaired genital tract patency. However, this situation can be explained by a trite - too short period of abstinence. The maximum threshold is conventionally set at 5-6 ml of sperm per ejaculation. Some doctors believe that the excess of this indicator may indicate prostatitis or orchitis,

Normal color seminal fluid ranges from milky white to grayish. An almost transparent sperm, even before a microscope is attached to the eyepiece, tells the technician about the low sperm concentration. But this can be explained, again, by the violation of the rules for preparing for spermogram, that is, by sexual activity on the eve of the test. Sometimes the ejaculate gets a yellowish tint, which may indicate the characteristics of the diet, taking certain vitamins or the development of jaundice. The pathological color of sperm is greenish, brown - unequivocally indicates an inflammatory or oncological process, as evidenced by exceeding the norm of leukocytes and erythrocytes and requires mandatory additional examination,

Smell seminal fluid is normally specific, sweetish, unsharp. The presence of an unpleasant smell (sour, putrid, like a rotten fish) indicates a pathology and is also a reason for conducting additional diagnostic procedures,

Consistency fresh ejaculate in the norm is such that it allows you to pull up the thread up to 2 cm in height, and an hour after ejaculation - up to 0.5 cm in height,

Liquefaction time sperm in a healthy man is about 30 minutes, maximum - 1 hour. Immediately after ejaculation, the ejaculate is very viscous, but then, under the influence of the enzymes it contains, it becomes more liquid. If this does not occur, the movement of sperm along the female genital tract is difficult, as a result of fertilization does not occur. The reason for the slow dilution of seminal fluid lies either in the inflammatory process or in enzymatic deficiency,

LevelpH sperm varies from 7.2 to 7.8, the maximum - 8.0. Therefore, healthy seminal fluid is alkaline. When deciphering the results of semen, the greatest concern should cause a significant decrease in pH - this indicates an inflammatory process in the male genital organs,

Total amount spermatozoa in one portion of the ejaculate should not be less than 40 million, the upper limit is 600 million. Therefore, the minimum concentration is 20 million spermatozoa per 1 ml of seminal fluid. In terms of fertility, the main danger is the reduction in the total number and concentration of sperm in the semen. But a significant excess of the norm also does not mean anything good. The causes are diverse: infections, endocrine, autoimmune and oncological diseases, circulatory disorders, sexual infantilism, bad habits, poisoning of the body, exposure to radiation,

Activity and Mobility must be no less than half of the sperm cells, with 25% of the total number being cells with a straight-line movement, which are most likely to successfully reach the uterus and fertilize an egg cell. The division of spermatozoa into 4 types, given in the table with the norms of spermogram, is currently not used everywhere. The following system is more relevant: with progressive movement (more than 25%), with non-progressive movement (more than 50%) and immobile spermatozoa (less than 10%),

The proportion of live sperm must be at least 50% of the total number of male germ cells, otherwise conception will be problematic. Of these, at least 30% should have the correct shape - an oval head and a moving tail. Deviations from the norm can be different: the head is too small or too large, while it is round, sickle-shaped or pear-shaped, and the tail is too short or long, not sufficiently twisted or forked, the structure of the neck is disturbed, and so on.

The proportion of immature germ cells in a healthy man's ejaculate is 2-4%. A significant excess of this indicator indicates a lack of secretory function. Modern reproduction experts are inclined to believe that this rate should be further reduced - to 1-1.5%,

Agglutination - This is an undesirable process of sperm coagulation between themselves, which, of course, interferes with their normal movement, therefore, interferes with conception. Such a violation occurs when decoding spermogram results very rarely and usually indicates toxic damage to the body or autoimmune disease.

Aggregation - This is the formation of complexes from sex and other cells glued together by mucus. This phenomenon is often associated with the presence of antisperm antibodies produced by the body of one or both partners, which leads to the so-called "immune infertility." The MAR test will help to establish the truth,

White blood cells sperm are always present, but in small quantities - up to 1 million in the entire portion of the ejaculate, that is, 3-4 cells in the field of view on a microscope slide. A significant excess of the norm on this indicator when decoding the results of spermogram indicates the presence of an inflammatory process (prostatitis, orchitis, vesiculitis, urethritis, etc.),

Red blood cells sperm should be absent, these are red blood cells that enter the seminal fluid only in case of a serious pathology - urolithiasis, a tumor in the organs of the genitourinary system,

Slime in ejaculate may be observed in small quantities. If there is a lot of it, it will lead to aggregation and reduced reproductive capacity. The reasons for the presence of large amounts of mucus in the semen, as a rule, are infectious-inflammatory, less often - immune.

Spermogram is done either manually or on an automatic analyzer. The first option is preferable, because the machine may malfunction, and a qualified technician with a microscope will set the exact figures.

The main thing to keep in mind is that bad semen results are not a sentence, you must repeat the study at least two times in order to draw final conclusions.

Meaning of terms in semen

When deciphering semen doctors use special terms that may be unfamiliar and incomprehensible to patients. Let's see what these words mean, and whether to panic after hearing them at the reception at your urologist.

Normospermia

This is a good result of semen - all indicators are normal. As a rule, a healthy man in 1 ml of ejaculate contains 60-80 million spermatozoa, of which about 70% are motile. The chances of successful conception, under the condition of good reproductive health of the partner, are very high, but still not 100%, since many factors influence this delicate mechanism, including even psychological mood.

In the ejaculate, both mature and immature forms of male germ cells are completely absent. If this is due to obstruction of the vas deferens, the man requires surgery, and if it is congenital testicular aspermia (the testicles do not produce spermatozoa), then any treatment, unfortunately, is futile.

Azoospermia

Spermatozoa in the ejaculate is not, but their immature forms are found. This suggests that the sex cells reproduce, but the process of their division and maturation is disturbed. It is possible to restore normal spermatogenesis, but success strongly depends on the cause, the severity of the pathology and the patient's desire to undergo treatment.

Oligozoospermia

This is a decrease in sperm concentration in the ejaculate. As follows from the table of spermogram standards above, the indicator of 20 million germ cells per 1 ml of seminal fluid is a kind of boundary. And that, successful conception will be possible only in the case when the majority of these sperm cells are viable, morphologically correct and mobile.

Cryptozoospermia

This is a condition where only single male sex cells are found in the ejaculate. You can find them using a special laboratory centrifuge. Cryptozoospermia suggests that the testicles can, in principle, produce spermatozoa, but serious therapy is required to get them working, and success will depend on the cause and severity of the pathology.

Oligospermia

Otherwise, the term sounds like "hypospermia" or "hypovolumia." This means that the volume of ejaculate is reduced compared with the norm (2-6 ml). Temporary oligospermia may be due to high sexual activity or frequent masturbation. About true oligospermia say when a man complied with all the rules of spermogram. Pathology can be explained by many reasons, ranging from inflammatory processes, ending with genetic abnormalities.

Polyspermy

Multisemia, multipolarization - these are all words that designate the release of too large volume of ejaculate at a time (more than 6 ml), as well as too high content of germ cells in it (more than 600 million). However, the majority of sperm will be immature, with impaired morphology and / or dynamics. All other indicators of semen, as a rule, normal. The cause of polyspermy is a failure in the process of spermatogenesis, treatment is possible.

Asthenozoospermia

Reducing the number of motile sex cells in the seminal fluid. As indicated in the table with the norms of spermogram results, progressively moving sperm must be at least a quarter of the total, 90% must show at least some kind of activity. With asthenozoospermia, sluggish and completely immobile sperm occupy 30% or more. There is also the term "asthenospermia", which characterizes the decrease in the rate of movement of male germ cells.

Teratozoospermia

More than half of the sperm have an abnormal morphology. In another way, this deviation is called teratospermia or anisozoospermia. Regardless of the reasons for the production of degenerative germ cells, attempts at conception from such a man (natural or artificial) are extremely undesirable, since it is fraught with miscarriage, missed abortion, fetal fetal defects.

Necrospermia

This condition is sometimes confused with akinospermia, that is, with complete immobility of sperm. But necrospermia is even worse - cells are not viable. Such a result of semen can be false, if the rules for collecting the ejaculate or analysis are violated - the substances that kill the spermatozoa are in the seminal fluid. Partial necrospermia is when living cells are less than 20% of the total. The true form is usually irreversible and does not respond to therapy.

Hemospermia

This means that blood is found in the semen. This happens not only in severe infections, but also in the presence of tumors, including malignant ones. A man with hemospermia is urgently examined for prostate cancer, especially if there are no signs of an infectious inflammatory process.

Causes of deviations from the norm

Spermogram results can be bad due to a number of factors:

Genetic anomalies - Kleinfelter syndrome, microdeletion of sections of the Y chromosome,

Endocrine pathologies - hypogonadism, hypothyroidism, hyperprolactinemia, dysfunction of the adrenal cortex, impaired hypothalamic-pituitary regulation, diabetes mellitus, high degrees of obesity,

Male urogenital diseases and injuries - cryptorchidism, varicocele, bruise and atrophy of the testes, orchitis, urethritis, prostatitis, vesiculitis, prostate adenoma,

Venereal and some other infectious diseases in the anamnesis - epidemic parotitis (mumps), syphilis, gonorrhea, chlamydia, mycoplasmosis, ureaplasmosis,

Toxic and radiation damage to the body - severe poisoning, working in hazardous industries, living in adverse environmental conditions, long-term medication with severe side effects, chemotherapy courses,

Bad habits - smoking, alcoholism, drug addiction, substance abuse,

Poor and monotonous diet, chronic malnutrition, vitamin deficiency, exhaustion, sudden weight loss,

Wearing tight, constraining clothing, poor-quality underwear made of synthetic fabric, as a result - overheating of the genitals,

Sitting work, sedentary lifestyle,

Frequent masturbation or sexual hyperactivity,

Why do sperm analysis?

According to the results of spermogramme, it is possible to assess the state of men's health, to identify prostatitis and other infectious diseases. If you have been trying to get a baby for a long time, but so far to no avail, the reasons will help to find out the analysis of the ejaculate for the number of spermatozoa and other indicators. With infertility, the results of spermograms will help the doctor to prescribe an effective treatment.

Spermogram: rules of delivery

According to the recommendation of the WHO (World Health Organization), spermogram delivery should be carried out by masturbation, and not by interrupted sexual intercourse or in any other way. To pass the analysis of semen, in the laboratory equip a specially designated room. The door in it closes from the inside. To make it easier to pass the analysis of ejaculate, in the room there are magazines of erotic content.

If you are assigned a spermogram, the rules of delivery suggest a 3-4 day training:

  • do not drink alcoholic beverages, including beer,
  • do not have sex
  • not to visit saunas, baths, and also not to take hot baths.

Repeated delivery of semen involves the implementation of the same rules.

To properly evaluate the results of semen, you must pass it several times. If after the first delivery of the semen the doctor said that the semen is bad, do not despair. When re-analysis of the sperm may have other characteristics. Changes in these characteristics can generally affect the interpretation of the sperm transcript.

Sperm Analysis: Medical Terms

To describe sperm, doctors use the following terms:

  • azoospermia - no sperm found in the ejaculate,
  • akinoseospermia - sperm cells are completely immobile,
  • antisperm antibodies (ACAT, or ACA) - antibodies that the body produces against sperm,
  • asthenozoospermia - inadequately motile sperm cells (category A) Time of liquefaction of the ejaculate

Normosaospermia involves sperm liquefaction within 10–60 minutes after ejaculation.

During eruption sperm is in a viscous state. After some time, the enzymes of the prostate gland, which are contained in the seed, dilute it. If the sperm does not liquefy, it indicates that the prostate gland is disrupted. Accordingly, the chemical composition of the sperm is wrong. This affects sperm motility and their ability to fertilize an egg. Due to insufficient liquefaction, there may be unhealthy indicators of sperm motility.

After ejaculation, sperm may die in the acidic environment of the vagina. In order for a sperm cell to fertilize an egg and safely pass this “barrier”, it needs protection. Such is the seminal fluid: it reduces the acidity of the vagina, and the sperm can get “alive” to the uterus.

If all semen readings are normal, except for pH, this does not indicate any deviations. But along with other characteristics may affect the diagnosis.

With azoospermia, a low pH indicates that the ejaculatory ducts are blocked.

Normospermia - 2.0–6.0 ml of semen.

An insufficient amount of ejaculate contains a small number of male germ cells. If the analysis showed that you have oligospermia, that is, when you ejaculate, an insufficient amount of sperm is secreted (less than 2 ml), this may be the cause of infertility.

A small amount of sperm also cannot protect spermatozoa from the vaginal acid environment for a long time and “punch” their way to the uterus.

To confirm the diagnosis of oligospermia, it is necessary to pass a semen analysis several times. Even if for the first time the volume was less than 2 ml, this is not a reason to worry.

If you emit more than 6 ml of semen during ejaculation, conception will not speed it up. The fact is that about 5 ml of semen is placed in the vagina. If during ejaculation you have more, an extra ejaculate follows and does not participate in the "Who's first" race.

What color is sperm from a healthy man?

White-grayish - the color of sperm in most cases (normospermia).

Yellowish, milky or white-milky - this color of sperm is also within the normal range (normozoospermia). The above shades do not indicate the presence of deviations. WHO recommends that neither the color of the sperm nor its smell be considered.

But in some laboratories, this characteristic is still recorded.

Thus, the pink color of sperm indicates an increased number of red blood cells in the ejaculate (hemospermia). With hemospermia, there may be a brownish tinge of sperm.

The transparent color of sperm indicates azoospermia (sperm does not contain sperm).

Normospermia implies their absence, and normozoospermia - not more than 1 million / ml.

Sperm analysis may indicate that the seminal fluid contains a small amount of white blood cells. If their concentration is less than 1 million / ml, this is normal. An increased white blood cell count (leukocytospermia) indicates inflammation in the prostate or seminal vesicles.

With the diagnosis of normospermia should not be in the semen.

A spermogram is bad if your sperm contains red blood cells. Hemospermia during sperm imaging is often observed in case of injury, swelling or inflammation of the prostate gland. Scarlet blood in semen (false hemospermia) indicates an injury or a disease of the urethra.

When hemospermia sperm brown or dark red. When ejaculation is accompanied by the release of semen of such shades, it is a sign of serious diseases of the reproductive system.The cause may be inflammation of the bladder, seminal vesicles or prostate.

In older men, hemospermia can be a symptom of prostate cancer. Recent studies have proven a link between hemospermia and prostate cancer: 14% of patients with hemospermia had cancer.

Hemospermia requires an individual approach to treatment. In this case, the doctor takes into account the patient's age, the duration of symptoms of hemospermia, and the frequency of their occurrence.

If there is mucus in the semen, the diagnosis of normospermia cannot be talked about. When sperm contains mucus during ejaculation, it is a sign of inflammation in the genitals.

The acidic environment of the vagina also kills the small amount of male germ cells that is released during ejaculation. Accordingly, even they do not have time to get to the uterus alive. Low sperm concentration (oligozoospermia) can cause infertility.

When azoospermia sperm count is zero.

Native sperm (untreated) can contain four categories of sperm:

If sperm moves in a straight line and passes more than half its own length per second (approximately 0.025 mm / s), it is assigned to this category. About half of all sperm from group A are healthy and young sperm that have recently been formed in the testicles.

Category B sperm is attributed if it moves rectilinearly, but its speed is less than 0.025 mm / s. As a rule, their ejaculation is 10–15%. These are spermatozoa, either aging, or with a broken structure.

Reduced mobility may be associated with prolonged abstinence from sex.

If the sperm rotates in place or in a circle, it is recorded in category C. Their number is usually from 5 to 15%.

This category records how many sperm do not move at all (azoospermia). Approximately 50% of all male germ cells of group D are old sperm cells that have either died or die.

Even if you are completely healthy and you have been diagnosed with normospermia or normozoospermia, sperm analysis can reveal the spermatozoa of all four groups.

If you have akinosis, you need to know what causes sperm immobility. To do this, use eosin. In this preparation, the dead spermatozoon turns red: its shell is quickly destroyed, and eosin easily penetrates into it. Eosin cannot penetrate into the live spermatozoon. If sperm does not stain and does not move, it indicates that the morphology is broken.

Sometimes during ejaculation, all the sperm are dead - this is necrozoospermia. It can be false and true. The causes of true necrosis are not fully understood - it is not treatable. With partial necrosis of living spermatozoa less than 20%.

If, after several semen transcripts, the doctor diagnoses necrosis, the couple is recommended either to adopt or to fertilize the donor with sperm.

Sperm: the structure of normal and abnormal forms

To exclude infertility, it is important to know how many spermatozoa have the correct and incorrect structure (morphology). Abnormal spermatozoa (with the wrong structure) move more slowly and have a lower frequency of the beating of the tail. In order to detect abnormal spermatozoa, a stained smear and an unprocessed - native - semen are used.

Sperm agglutination is their sticking. Another name for this process is spermagglutination. She points to inflammation in the gonads and immune system disorders. With sperm agglutination, in most cases you can conceive a child in a natural way. But spermagglutination almost always reduces the speed of movement of male germ cells.

ACAT is the immunoglobulins (proteins) of groups A, M, and G. Anti-sperm antibodies cause one spermatozoon to stick to another. ASAT is formed in the body of both men and women.

ASAT can cause infertility. If the sperm is stuck together with the ASAT flagellum, it moves more slowly, if with the head it cannot fertilize the egg. In order to identify them in the ejaculate, the MAR test is most often used (in English, the mixed immunoglobuline reaction is - the reaction of immunoglobulins when mixed ’). If the spermogram in the MAR test item is zero, it means that you have not found ASAT.

Causes of sperm immobility

If immobility or very low sperm motility is detected, its causes can be:

  • alcoholic drinks,
  • tight underwear
  • genital diseases,
  • smoking (tobacco, marijuana, etc.),
  • intimate lubricants,
  • hypovitaminosis,
  • stress.

Low sperm motility may also be associated with an abnormal structure that has sperm.

How to increase sperm motility

When body temperature rises and ejaculation occurs, an increase in sperm motility is observed, and a decrease in at room temperature. Accordingly, the interpretation of the spermogram directly depends on the conditions in which the analysis was carried out. If you do the analysis in a room with a temperature of 10 ° C, then low mobility will be even in quite healthy and young male germ cells. Therefore, for the analysis in laboratories use special thermal tables that maintain a temperature close to the body temperature.

Opportunities partner to become pregnant significantly reduced if the doctor has diagnosed asthenozoospermia. But even when there is an increase in sperm motility, this is not a guarantee of 100% pregnancy.

How to increase sperm motility, the doctor will tell you. To improve sperm motility, antioxidant complexes that bind free radicals in the body help.

British researchers tried to figure out how to increase sperm motility. In the experiment conducted by the BBC, there were several men who could not conceive a child for two years. After analyzing the semen men were diagnosed with teratozoospermia, that is, a large number of abnormal spermatozoa. Their sperm also showed low sperm motility.

A nutritionist has developed a nutrition system with plenty of antioxidant vitamins for participants in the experiment. Every day, in the morning and in the evening, the men drank a glass of fruit or vegetable juice. After three months, when re-analyzing the sperm of the subjects, experts observed an increase in sperm motility.

After six months from the beginning of the experiment, the immobility of spermatozoids not only disappeared in men - the partner of one of them even became pregnant. According to the results of spermograms, specialists observed an improvement in sperm motility in all participants in the experiment.

At the end of the study, scientists from England concluded: when taking antioxidant vitamins, not only sperm morphology improves, but their mobility increases.

If you do not know how to increase sperm motility, consult your doctor.

What determines the quality of semen

Immediately, we note that, for the most part, the test results do not depend on where to make the spermogram. It should be said that the reproductive function of the male genital organs is influenced by many factors, among which almost in the first place is stress. It implies not only the nervous tension itself, but also toxicological, infectious and physical irritability, as well as everything that can bring the human body out of a comfortable state. If you follow your daily routine and minimize harmful effects, the quality of spermograms will improve on its own over time, because our body has an amazing ability to self-regulate. For this you need:

  • To live in a place with a favorable environmental situation,
  • Engage in active sports at least 3 times a week,
  • Watch your diet,
  • Eliminate bad habits
  • Observe the mode of work and rest.

Guided by these simple recommendations, in a short time the general condition of the body will improve significantly, and with it the quality of the spermogram will rise. If a man has previously led a healthy lifestyle, then the hormonal state of the body can only be improved through special medical therapy, which ensures a high result rather quickly. However, compared with the “natural” methods, this approach gives a short result. When spermogram-morphology is carried out, not only motility and sperm count, but also their appearance, is evaluated. Such an analysis provides an accurate picture reflecting the state of the male reproductive organs.

How is spermogram-morphology evaluated and what to do if it showed disappointing results?

It should be said that the conduct of spermogram on morphology is carried out, guided by certain criteria for the appearance of each individual spermatozoon and their combination. The most common pathologies classified by Kruger are:

  • Macro and micro heads,
  • Split head or tail,
  • Pear head,
  • Morphological pathology of the neck or head.

Far from always disappointing results spermogram morphology means the pathology of reproductive organs or impaired reproductive function. Fortunately, modern medicine can solve most of the problems, so specialized hormone or supportive drugs are assigned to improve the condition, allowing you to quickly increase the quality of spermograms, which will further lead to the desired pregnancy and the birth of a healthy child. Remember that a man has a big responsibility, because even with excellent health, the expectant mother, with poor sperm quality, is unlikely to have a full-fledged, healthy baby.

Watch the video: Sperm Count. Nucleus Health (September 2019).