Many representatives of the stronger sex were faced with the need to donate sperm for analysis. This need can be caused by various reasons. Men who go to get tested for the first time often have no idea how the procedure will go. Therefore, it is better to prepare physically and mentally for this action in advance.
How to take a sparmogram correctly
It is recommended to carry out a spermogram in multidisciplinary clinics, artificial insemination or reproductology centers. You can also get tested in a private laboratory. Your attending physician and reviews of clinics will help you choose the right medical institution.
The entire procedure for studying male ejaculate can be divided into several parts:
- competent preparation for the delivery of biomaterial;
- the process of obtaining sperm;
- studying the material in laboratory conditions;
- interpretation of the result.
Having prepared accordingly, a man with a passport and a doctor’s referral must appear at the chosen clinic at the appointed time. There he will be asked to purchase a sterile disposable plastic container with a lid on which to indicate his data.
It is also acceptable to use a glass container that has been previously washed and sterilized by boiling for at least 10 minutes.
The lid of the jar should be removed only at the moment of ejaculation to prevent foreign bacteria from entering the container.
For analysis, sperm must be collected in a disposable plastic container.
- Firstly, part of the sperm may be lost, while determining the exact amount of ejaculate is one of the main diagnostic points in the analysis.
- Secondly, impurities in the form of female flora contained in the vagina can get into the biomaterial.
The use of a condom is not allowed, since all rubber products are treated with spermicidal lubricants, which have an extremely negative effect on the quality of sperm.
Video: how sperm is submitted for analysis
Paid medical centers have special rooms where a man can sit comfortably and calmly receive material for analysis. Such rooms are equipped with comfortable furniture, a washbasin, and a display for playing the corresponding video sequence. It is possible to invite a spouse who can help her husband take the test (oral stimulation is not allowed). Having reached orgasm, the man collects the ejaculate in a container and immediately transfers it to the laboratory.
Regular clinics do not have such rooms. The man will simply be offered an empty closed room where he can get tested.
Paid clinics provide convenient facilities for sperm donation As an exception, a laboratory sample can be obtained at home. But in this case, it is necessary to strictly fulfill certain conditions in order to avoid poor-quality diagnostics and, as a result, unreliable analysis results:
- sterility;
- fast transportation - the journey to the laboratory should take no more than 60 minutes (the less, the better);
- compliance with the temperature regime - only at body temperature (the easiest way to comply with this condition is by placing the container with sperm under the armpit).
Sequencing
The sequence of actions for directly obtaining ejaculate:
- Psychological mood.
- Emptying the bladder.
- Clean your hands thoroughly with soap.
- Masturbation with bringing yourself to orgasm.
- Collect the material in a sterile container (without swinging the penis and hands into its inner walls).
- Transfer of material to the laboratory.
It is necessary to obtain a sample for a spermogram through masturbation. Traditionally, it is believed that sperm can be donated at any time of the day. But many experts say that sperm are most active in the early morning hours. The peak of their “performance” occurs at 6–7 hours.
Once you receive the results, you should not try to interpret them yourself. Deviations from the norm are not yet a reason to panic. It must be remembered that spermogram indicators are not constant, since the composition and quality of seminal fluid and sperm changes depending on the condition of the male body. A banal lack of sleep or troubles at work can play an important role in this matter. Therefore, it is worthwhile to properly prepare for the test.
Video: how to decipher a spermogram
What does proper preparation for analysis include?
A man interested in a reliable analysis result must pay special attention to his body before the procedure. The preparatory stage consists of a whole set of rules that must be followed without exception.
Nutrition
At least a week before donating the ejaculate, you need to remove fatty and fried foods, hot sauces, spices, soy, coffee and strong tea from your diet, as these products negatively affect the quality of sperm. The table should have dairy products, protein foods, vegetables and fruits. Food should be rich in vitamins E, B and C.
Before a spermogram, a man must change his diet if it does not meet healthy eating standards Health status
The presence of acute inflammatory processes in the body in a man is a direct contraindication to donating sperm. A person must be healthy - he should not have a common runny nose, much less diseases of the genitourinary system. They must be cured and tested no earlier than after 7–30 days, depending on the type of pathology. The doctor will tell you exactly when.
By the way, if a man is prescribed a prostate massage due to any disease, it cannot be performed for 3 days before the test, since the procedure can significantly distort the spermogram parameters.
Alcohol
Alcohol in any form is excluded. This applies not only to strong drinks, but also to low-alcohol drinks, including beer. Ethanol has a negative effect on sperm activity and the quality of seminal fluid. Various energy drinks and nicotine have the same effect. You should abstain from harmful libations and tobacco for at least 10 days.
Video: the effect of alcohol on sperm
Sex life
Before taking the test, you should avoid sexual contact for 2–7 days. It is during this period that the accumulation of mature and maximally active sperm occurs. Abstinence for longer periods of time is not beneficial. It leads to stagnation of seminal fluid and death of germ cells in the seminal vesicles.
Sexual abstinence for 2–3 days is a prerequisite before taking a spermogram Physical exercise
2-3 days before donating sperm, you need to limit heavy loads as much as possible, since the biochemical processes occurring in the body during such stress significantly worsen the quality of the ejaculate. It is recommended for a man to take a few days off if his profession involves daily physical labor, and strength training in the gym can be postponed until later.
Preparing to donate sperm for analysis is exactly the time when a man can rest Emotional condition
Emotional stress, like physical stress, negatively affects spermogram results. Before taking the test, you need to have a good rest, sleep (at least 8–9 hours), and have a positive attitude.
Overheating
Visiting a bathhouse, solarium, saunas, steam rooms, and even taking a hot bath before taking the test is also prohibited. Overheating negatively affects spermatogenesis. This issue should be kept under control for at least a week before the spermogram.
Visits to baths and saunas are harmful to spermatogenesis; these procedures can distort the results of the analysis Taking medications
Many drugs can have a significant effect on the condition of sperm. Therefore, this point must be discussed with your doctor, especially if you have to take some medicine constantly.
Video: preparation for spermogram
How is the analysis carried out?
The result of the analysis, as a rule, can be obtained in most clinics on the same day. If, in addition to the standard spermogram, sperm culture was carried out, then it takes longer to prepare - 3–5 days.
Usually analysis alone is not enough. Considering the possibility of changes in the quantitative and qualitative composition of sperm, the doctor most often prescribes a second analysis, and if there are significant discrepancies in the results of the first two spermograms, a third one. About 2–3 weeks should pass between tests, less often - 7 days. The duration of the intervals between tests is determined by the doctor.
The analysis itself consists of assessing the total number of viable germ cells and the number of active sperm capable of fertilization, as well as the quality of the seminal fluid.
A spermogram consists of assessing the quantity and quality of sperm and the condition of seminal fluid relative to established standards. The analysis involves 2 stages:
- macroscopic study of the properties of the material - volume, consistency (uniformity and absence of lumps), liquefaction time, viscosity, color index, acidity;
- microscopic examination - the number of sperm, the number of motile and non-viable ones, the activity of living germ cells, the number of leukocytes or erythrocytes.
Video: what sperm parameters are studied
Methods to improve sperm quality
You can improve sperm to increase fertility by many means, including medications. But you need to remember that to achieve the best results and lasting effect, sometimes you need to change your lifestyle.
Factors that improve male fertility:
Video: how to improve sperm
Drugs to improve sperm count
The products for improving male fertility include vitamins and vitamin-like substances (levocarnitine), amino acids (L-arginine, taurine), enzymes, and trace elements. All means - dietary supplements, vitamin-mineral complexes, homeopathic preparations - are aimed at increasing the number of germ cells, increasing their viability, improving the quality characteristics of seminal fluid, as well as enhancing erectile function.
Most often, to stimulate spermatogenesis, a man is prescribed drugs:
- Spermaplant with amino acids and vitamins.
- Vitaprost containing prostate extract. It is used to improve the quality of ejaculate and normalize the parameters of the prostate gland.
- Speroton powder containing zinc, L-carnitine and vitamin E.
- Wobenzym is an enzyme preparation as an immunomodulator.
- Tribestan is a herbal remedy containing Tribulus herb. It has a stimulating sexual function and a general tonic effect. Increases the number of germ cells and their mobility.
- Speman is a complex homeopathic drug that has immunomodulatory and spermatogenesis-stimulating properties.
- Profertil is a dietary supplement with vitamin E, zinc, selenium, folic acid, coenzyme Q10, L-arginine, L-tartrate, levocarnitine, L-glutathione.
- Viardot capsules with wheat germ oil (contains phytosterols, tocopherol, zinc), Selexen (a source of selenium). The product activates testosterone.
- Homeopathic medicine Coenzyme compositum as an immunomodulatory, metabolic, antioxidant agent.
Vitamin complexes for men's health must contain the following components:
- B vitamins - take part in the synthesis of male sex hormones and enhance sperm activity;
- vitamin C - plays the role of an immunomodulator, ensures normal blood flow to the genitals, participates in spermatogenesis, enhances potency;
- vitamin E - affects hormonal levels, improving the functionality of the testicles and protecting the hormones they produce from oxidation;
- vitamin A - activates the synthesis of male sex hormones;
- zinc - regulates male sexual function, participates in the production of testosterone, improves sperm quality;
- selenium - participates in the biosynthesis of testosterone and sperm, regulates its qualitative composition;
- amino acid taurine - is involved in many vital processes in the body, including the regulation of the immune system and metabolism;
- folic acid (vitamin B9) - normalizes sperm quality, reduces the number of sperm with morphological defects;
- amino acid levocarnitine - exhibiting strong antioxidant properties, increases sperm volume and the likelihood of conception, increases the concentration of healthy sperm;
- amino acid arginine - enhances potency and improves the quality characteristics of the ejaculate;
- magnesium - having antioxidant properties, has a positive effect on male sexual function.
- Alphabet for men with minerals, vitamins, amino acids and Siberian ginseng extract;
- Selenium forte - with selenium and vitamin C;
- Mens formula is a complex specially designed to enhance sexual function;
- Vitiron suscaps - soluble capsules with a rich vitamin composition;
- Oligovit is a vitamin and mineral complex that provides the daily requirement for substances necessary for men's health.
Photo gallery: means to improve spermatogenesis
Tribestan - a drug for the qualitative improvement of Viardot's ejaculate with wheat germ oil has a positive effect on all body functions, including sexual function. The alphabet for men is designed taking into account the needs of the male body. 
Speroton - a drug for the quality improvement of sperm Mens formula - an effective remedy for increasing spermogram indicators 
Spermaplant is often prescribed to men with infertility 
Selenium forte provides the male body's need for this microelement Profertil improves male fertility Speman - a homeopathic remedy for improving sperm
Products to enhance male fertility
Of course, vitamin supplements alone are not enough to normalize men’s health. Diet is very important. A man must receive the necessary substances from food every day.
Table: foods most valuable for the male reproductive system
| Group | Products | What they contain and how they are useful |
| Plant food | They contain a large amount of the “male” microelement zinc, which regulates testosterone levels. Men are recommended to eat a handful of any nuts every day. |
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| Bananas |
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| Fresh herbs, garlic |
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| Citrus | Contains a lot of vitamin C, which has a positive effect on the immune system | |
| Avocado | Vitamin E contained in fruits improves seminal fluid and germ cell motility | |
| Tomatoes | Rich in vitamin C and lycopene, which improves blood supply to various organs and has antioxidant properties, which has a positive effect on a man’s hormonal status | |
| Apples |
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| Grenades |
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| Pumpkin seeds | A very healthy product containing almost all B vitamins, vitamins E, A, C, K, and many microelements, including magnesium, phosphorus, selenium and zinc. Regularly consuming a portion of delicious seeds can significantly improve your sperm count. | |
| Vegetable oils | They are a source of vitamin E, vitamins B and A. They influence various stages of the biosynthesis of sex hormones. | |
| Celery | Contains many vitamins, zinc, magnesium and phytosterols, therefore it is a herbal regulator of sexual function | |
| Asparagus | It is famous for its high content of a whole complex of vitamins and microelements, including folic acid | |
Dried fruits:
| Rich vitamin and mineral composition helps normalize hormonal levels and improve sexual function | |
| Animal food | Oysters | Due to the high content of omega-3 acids, selenium, zinc, iodine and other elements, they rank high on the list of products that improve sperm quality and male fertility in general. |
| Seafood and red fish | Polyunsaturated fatty acids contained in seafood have a positive effect on blood vessels, metabolic processes, and are involved in spermatogenesis | |
Meat:
| Dietary meat is rich in protein, vitamins, macro- and microelements. Turkey breast is especially healthy because it is high in selenium and zinc. | |
| Chicken and quail eggs | They increase male potency by saturating the diet with protein and beneficial microelements and vitamins. It is recommended to eat 1 chicken or 2-3 quail eggs per day. | |
Dairy products:
| They are a source of protein and vitamins, important for normalizing the quality of ejaculate. |
Photo gallery: products to improve sperm count
Bell peppers are a source of vitamin C, necessary for the normal functioning of the immune system. Nuts contain vitamin E, a regulator of sexual function. 
Buckwheat contains zinc, which is necessary for the production of healthy sperm. Spinach is high in folic acid (vitamin B9), which is a regulator of reproductive functions. Salmon is a source of omega-3 polyunsaturated fatty acids, necessary for the general health of the male body. Sesame seeds are a supplier of arginine, amino acids, necessary for the synthesis of sex hormones and the production of high-quality sperm Eggs contain selenium, which is involved in the biosynthesis of sex hormones Beef liver is a source of B vitamins, the most important substances that influence all stages of hormone synthesis
Natural honey and bee products are very useful for men: propolis, beebread, drone milk. Based on them, you can prepare products that will have a beneficial effect on the state of the reproductive system.
Nut-honey infusion:
- Chop shelled walnuts (3 cups) and pour in a glass of honey.
- Mix and take 2 tablespoons 2-3 times a day.
- Nuts can be replaced with ground pumpkin seeds.
Propolis tincture:
- Take 20 g of the substance, pour vodka or medical alcohol (80 g).
- Leave for a week in a cool place.
- Drink 30 drops before meals three times a day for 2 weeks.
Beebread (pollen soaked in honey in honeycombs) is an excellent remedy for improving fertility. It is recommended to eat 2-3 teaspoons of bee bread every day before meals for 3 months.
Drone jelly (homogenate) is a good remedy for activating spermatogenesis. It is advisable to take 1 teaspoon on an empty stomach daily for 2 months. The product must be dissolved in the mouth.
All bee products have a positive effect on male fertility rates
A man’s reproductive ability is a factor that ensures not only the possibility of pregnancy in a woman, but also determines how healthy and complete the future offspring will be. The ability of the male body to reproduce is largely determined at the genetic level, but a person can consciously improve or worsen its condition. The fact is that the physiological production of hormones and germ cells in the male body directly depends on the tendency to bad habits, quality nutrition, as well as activity in lifestyle. Those married couples who have not had children for a long time need to pay attention not only to women’s health problems, but also to determine the degree of men’s health.
Male fertility, that is, the ability to fertilize, depends on the quality of the sperm produced, therefore, in order to determine its properties, a number of special medical examinations are performed, one of which is a spermogram.
Peculiarities
Sperm is a cloudy and viscous substance that consists of components of the secretory activity of the gonads of the male body. Sperm consists of seminal fluid produced by the seminal vesicles and prostate gland, as well as formed elements called sperm. They make up only 5-6 percent of the total sperm volume and are the object of study of the spermogram.
A spermogram is an analysis of male ejaculate (sperm), which shows the ability of the formed elements (sperm) to fertilize. Any spermogram involves consideration of the macro- and microscopic characteristics of the material being studied. Upon macroscopic examination, the quantitative indicator of the obtained sperm, the color of the material, the rate of the liquefaction reaction, the viscosity and the acid-base environment of the ejaculate are determined.
A microscopic examination will show the quantitative content of male germ cells, their mobility, morphological structure, and will also determine the presence of leukocytes, erythrocytes and the number of still young, immature sperm that appear during the process of spermatogenesis.
Kinds
In order to identify and eliminate the causes of infertility, a man undergoes various types of sperm analysis, which help to check what exactly is the problem of his inability to fertilize. Modern medicine carries out sperm examination using various methods. In each case, the reproductive specialist selects exactly the necessary set of diagnostic procedures that will help collect the most accurate and comprehensive information about problems associated with spermatogenesis. There are the following types of sperm examination:
- Basic spermogram, performed according to generally accepted WHO (World Health Organization) standards and assessing the overall process of spermatogenesis from the point of view of biochemical analysis.
- Spermogram according to Kruger is a morphological analysis of male germ cells, which allows one to determine the quantity and quality of sperm of normal physiological structure versus cells with abnormal development.
- Electron microscopy of sperm (EMIS)– the method allows you to identify deviations in the structure of male germ cells that occur in a man’s body at the gene level. Analysis is resorted to when the basic spermogram reveals reduced motor activity of sperm and a large number of atypical specimens based on morphological characteristics are identified.
- Sperm DNA fragmentation (Tunel)– the analysis informs about the genetic makeup that will be passed on to the unborn child through male reproductive cells. This method will allow us to accurately determine all pathological processes and hereditary diseases transmitted to offspring through the male line. This technique is often prescribed to men with pathology of the spermatic cords, as well as for long-term inflammatory diseases of the reproductive and urinary systems.
- MAR testing reveals the presence of an autoimmune factor leading to infertility. Using the test, you can detect the presence of antibodies that are produced by the body due to autoimmune aggression against its own sperm. This pathology is extremely rare, but when there is a question about identifying the causes of infertility, it is often recommended.
- Test for acrosin levels in semen– determines the degree of possibility of conception and acceptance of sperm by the uterus. This process is regulated by a protein called acrosin, which is found in sperm. Increased levels of acrosin in sperm with a clearly reduced motor activity of sperm are a factor that contributes to the possibility of sedentary sperm being introduced into the female egg through its membrane membrane and mucus, which is located in the cervix. The level of acrosin in the ejaculate provides information about the possibility of a successful fertilization process.
The combination of different types of sperm examination is reflected in the so-called summary analysis - a fertility map. This summary analysis determines the level of male health, a man’s ability to fertilize, and also provides information about how healthy his offspring will be.
Indications for use
A spermogram is a fairly informative method for diagnosing male fertility. It is prescribed in the following cases:
- When, within 1-3 years, subject to regular sexual activity and the absence of the use of contraceptives in a couple of childbearing age, a woman does not become pregnant.
- In the case where a man has suffered a trauma to the pelvic organs, been exposed to X-rays or ionizing radiation, suffered infectious diseases or sexually transmitted diseases, the man has a congenital pathology of the reproductive organs, or these may be pathological processes that have arisen for one reason or another (for example, varicocele ).
- Before carrying out the in vitro fertilization procedure, the qualitative characteristics of the male ejaculate are checked.
- For preventive purposes for timely diagnosis and treatment of pathologies of the reproductive system of the male body.
- Before donating sperm as a donor.
A spermogram is necessary to obtain a full consultation and medical assistance in matters related to men's health and ability to reproduce. This analysis is the starting point to begin identifying the causes of male infertility. The results obtained influence the tactics of treating men and methods of fertilizing women in infertile couples.
Preparation for delivery
In order for the spermogram results to be most accurate and reliable, a man, as a rule, prepares in advance for submitting sperm for analysis. There are certain rules for such preparation that must be strictly followed. The fact is that certain circumstances affecting men can significantly distort the true picture of sperm. In general, these factors can be divided into external and internal.
External reasons include the temperature conditions under which sperm was collected for analysis, as well as the cleanliness of hands and the sterility of the analysis container. Internal reasons are much more diverse - the composition of sperm is influenced by general well-being and health indicators, the composition of the daily diet, the presence of bad habits and even the impact of unfavorable environmental conditions.
Basic principles of preparing for a spermogram:
- Balanced diet– in order for the amount of sperm produced to be sufficient and sperm motility to be maximum, it is necessary to adhere to a healthy and balanced diet 7-10 days before the test. It is required to refrain from consuming spices, herbs and herbs, and also to remove salted, smoked and pickled foods and any canned food from the diet. Avoid drinking coffee, black tea, and synthetic carbonated drinks. Do not eat fried foods, exclude fast food. The diet should include dairy products, lean meats, fish, poultry, as well as a large amount of vegetables and fruits. You can use grains and nuts.
- Elimination of harmful addictions– at least three months before planning a pregnancy or having a spermogram, a man must completely eliminate alcohol, smoking and drugs. It has been proven that alcoholic drinks cause the ejaculate to become liquid, and the number of living and mobile sperm in its composition is significantly reduced. In addition, alcohol and drugs lead to mutational changes in sperm and this mutation is passed on to the offspring at the genetic level, resulting in the birth of children with congenital anomalies and genetic diseases.
The body needs at least 3 months for the entire composition of sperm to be renewed as a result of spermatogenesis. If it is not possible to quit smoking, it is necessary to reduce the number of cigarettes consumed as much as possible.
- Sexual abstinence – at least three days. If you do not comply with this norm, then the amount of sperm sent for analysis will be reduced, and its composition will be liquid (which means the number of sperm will be reduced). If the process of abstinence exceeds 4-6 days, this will also negatively affect the results of the analysis - the sperm will be too thick, clumping will be observed between the sperm, and the number of living and mobile cells will be reduced.
- Exclusion of medications– after taking a course of antibiotics, at least three weeks must pass before submitting sperm for analysis. In the case where a man was taking hormonal medications, the pause before the analysis should be at least one month. Painkillers and anti-inflammatory drugs should be stopped 10-14 days before the spermogram. The same period should be maintained after taking anticonvulsants or psychotropic medications.
If a man does not have the opportunity to avoid taking these drugs and is undergoing a course of treatment, then a spermogram is performed only after completing this course and after the required amount of time has passed for the complete removal of drugs from the body.
- Temperature compliance - 10 days before the sperm test, you must avoid visiting a bathhouse or sauna, and also avoid exposure to high temperatures. With excessive heating of the male reproductive organs, active death of motile sperm occurs and for this reason the spermogram indicators deteriorate. Even heated seats in vehicles can have such a negative impact on sperm quality.
- Dosed psychological and physical activity– before taking the test, you should avoid excessive physical and emotional stress for 3-5 days. It is advisable to exclude stressful situations and night work so that it is possible to maintain a sleep and rest schedule. Even excessive participation in sports can reduce the quality of sperm, so before the examination it is not recommended to visit the gym, and extreme sports are even more contraindicated.
- Eliminate mechanical irritants– before taking a spermogram, 3-5 days before taking a spermogram, it is necessary to abandon mechanical examinations of the prostate gland, and also not to perform prostate massage sessions. Under the influence of mechanical stimuli, the prostate gland activates the production of fluid, which enters the sperm and dilutes it. In addition, it is necessary to exclude various injuries to the reproductive organs - if they are present, the analysis will have to be postponed to a more favorable time.
If you follow these recommendations, the spermogram results will be as close as possible to your physiological norm, which will help the fertility doctor reliably assess the situation existing at the time of the examination and your chances of fertilization.
How is it carried out?
In various medical institutions, the requirements for the method of donating sperm for analysis can be of two options - either the material is collected within the walls of the medical institution, or patients deliver and submit it to the laboratory on their own.
When taking a spermogram in a medical facility, the ejaculate is collected in a sterile container by masturbation. For this, the man is given a special room where he can wash his hands and carry out the procedure for obtaining biomaterial. After the sperm is collected, it goes to the laboratory, where it is immediately examined. This is the method recommended for sperm collection by the World Health Organization.
If the procedure for collecting material is carried out at home, the collection of ejaculate can be carried out either in a sterile container or in a condom that is not treated with a lubricant coating, which can destroy sperm. Next, the material must be delivered to the laboratory for analysis no later than one hour from the moment of its collection. When transporting sperm, it must be remembered that its safety depends on the ambient temperature - it should be equal to the temperature of the human body - 36.6 degrees.
When collecting sperm for analysis, it is important to observe the necessary hygiene requirements - hands and the external genital area must be washed with detergent. The material must be collected carefully into a sterile container, trying not to touch its inner walls. It is important to collect the entire amount of ejaculate produced without loss - otherwise the analysis will be unreliable and will have to be redone.
Decoding
When deciphering the results of a spermogram, specialists use certain terms that are common to all medical institutions and are universally accepted for use by the World Health Organization:
- normozoospermia – the state of sperm corresponding to the values of the reference norm;
- aspermia – complete absence of sperm;
- oligospermia – the quantitative indicator of the delivered ejaculate is less than the physiological norm of its production;
- azoospermia – we are talking about ejaculate where there are neither mature nor young germ cells;
- cryptozoospermia - the sperm count is so low that it is difficult to detect;
- asthenozoospermia – the motor ability of sperm is below normal;
- akinozoospermia – we are talking about the complete absence of sperm motility;
- oligozoospermia – the number of sperm in the ejaculate is below normal levels;
- teratozoospermia – the number of morphologically healthy sperm is below normal;
- necrozoospermia – there are no live sperm in the ejaculate, but dead cells are found;
- hematospermia - blood is present in the semen in the form of erythrocyte cells;
- leukocytospermia - the number of leukocytes is higher than normal.
When a combined pathology is detected, it is customary to combine some terms into one word - for example, “oligoteratozoospermia”, “asthenoteratozoospermia”.
Standard indicators
In 2010, the World Health Organization revised the previously existing standard indicators for the analysis of seminal fluid due to the improvement of methods for conducting research on this biomaterial. According to the new adopted standards, the following are considered standard indicators:
- quantitative indicator - from 1.5 milliliters and above;
- sperm count – from 39 million and above;
- sperm concentration in 1 milliliter of test material – from 15 million and above;
- the total number of motile sperm is from 4% percent and above;
- the total number of sperm with progressive movement is from 32% and above;
- the overall sperm viability rate is 58% and above;
- The overall rate of sperm with normal morphology is 4% or more.
In addition to these indicators, semen testing is also carried out according to other parameters:
- The rate of dilution of seminal fluid and its viscosity - normally, the ejaculate is able to turn from a viscous state into a liquid state over a period of time ranging from 15 to 60 minutes. In the case when, after the specified period, the sperm has not become liquid, it means that it is incapable of liquefying at all. For further research, non-liquefiable ejaculate is liquefied using enzymatic proteolytic components.
- The acid-base reaction of the ejaculate – normally, this indicator, according to WHO, should be at least 7.2. A healthy man will typically have a pH reading in the range of 7.7 to 8.0.
The color indicator of the seminal fluid is not of great importance for diagnosis, so the spremogram test contains this information, rather, as a traditional indicator. Sperm can have good characteristics in any color shade – from white to grayish. However, pink and yellow tones in the color of the ejaculate indicate that there is a certain inflammatory process or a defect in the integrity of the tissues in the reproductive organs.
The change in sperm color may be temporary - for example, after injury, the situation returns to normal within a few days and the test results return to normal. For this reason, the test should not be taken immediately after an injury. But there are also situations of long-term persistence of reasons unfavorable for spermatogenesis, for which the spermogram picture is far from ideal.
So, for example, with varicocele, the situation requires surgical treatment and some rehabilitation - only after this can we expect an improvement in spermogram indicators.
Possible violations
An indicator that a man is diagnosed with infertility is most often the pathology of the morphological structure of sperm. The greater the quantitative composition of sperm cells that have pathological forms, the more the likelihood of natural fertilization and the birth of full-fledged offspring decreases.
The following pathologies of the morphological structure of sperm are distinguished:
- asymmetrical position of the acrosome and the junction of the sperm body with its head part;
- complete absence of acrosome in sperm;
- abnormal number of head or tail parts - two tails or two heads;
- abnormal sizes of the head part of the sperm - either too small or too large heads;
- abnormal shapes of the structure of the head part of the sperm - round, pear-shaped, cone-shaped or irregularly shaped;
- in the structure of the head part of the sperm, the cytoplasm exceeds its normal size or is completely absent;
- between the head and middle part of the body of the male reproductive cell there is an angle exceeding 90 degrees;
- uneven thickness of the length of the middle and/or tail part of the sperm;
- the flagellum, with the help of which the sperm carries out forward movements, is of insufficient length, is located at an angle or is twisted;
- vacuoles are found in the head part of the cell;
- abnormal structure of the sperm, expressed in an increase or decrease in the normal size of its parts.
The abnormal development of male germ cells can be influenced by genetic predisposition, injury, disease, and infection. Pathological changes can be in one of the listed options, but, as a rule, they occur in combinations with each other.
A conclusion about the reversibility of the detected unfavorable processes of spermatogenesis can only be given by a doctor based on additional examination methods.
In addition to morphological disorders in the structure of male germ cells, another pathology of sperm may occur, which is called spermagglutination. This term refers to the gluing of spermatozoa to each other.
However, it is necessary to distinguish agglutination from aggregation, in which the gluing of sperm occurs due to a large amount of viscous mucus in the ejaculate and is not a pathology. During the process of agglutination, sperm are glued together in a specific way - head to head, tail to tail. As a rule, few such areas of glued sperm are found, while during aggregation large lumps of glued cells are formed.
How to improve?
If a spermogram reveals a sperm pathology, reproductive doctors will recommend that the man undergo a certain course of measures that will be aimed at eliminating the causes that caused these problems. With the help of therapeutic measures, a man’s hormonal levels are normalized, sexually transmitted diseases are eliminated, and diseases of infectious etiology are also treated.
Surgical measures are resorted to in extreme cases when therapeutic methods of treatment are powerless, for example, with varicocele.
If for one year a sexually active young couple tries to conceive a child, does not use any contraception, but there are no results, we can talk about the possibility of male fertility. We are talking about either low sperm quality, sperm passivity, or even male infertility. And the sooner a representative of the stronger sex visits a doctor for further diagnosis and search for problems, the more chances he has to fix everything.
Most often, the doctor, after talking with the patient, sends him to the laboratory to do a spermogram. A spermogram is a laboratory study of a man’s ejaculate, that is, his seed. And in order for the analysis to be successful and show accurate results without errors or errors, proper preparation for the spermogram is important, as well as the subtleties of its decoding and understanding.
What is a spermogram?
With the help of modern medicine and equipment in the laboratory, it is possible to study the composition and properties of a man’s semen in order to clarify the possibilities of his reproductive function and the causes of problems with conceiving a child. To do this, a specialist takes a seed, examines it under a special microscope, after which he can accurately assess how capable a man is of conceiving future offspring.
If the transcript of the spermogram shows any deviation from the norm, the doctor does not always make a disappointing diagnosis. Such data do not guarantee complete dysfunction, but on the contrary, they only indicate reduced fertility. It is possible to exclude a man’s reproductive function only after a long time of trying, undergoing many tests and examinations.
Where can I get a spermogram?
To undergo a course of examination and obtain accurate information about the possibility of having a child, a man needs to visit a district or regional clinic, namely the urology department. If this is not the case, most likely the patient will be sent to a dermatovenerology clinic or a specialized clinic for men. In modern society, private clinics are also popular.
For reference! The price for diagnostics and examination in a clinic is much lower than in a private center, but the conditions for donating semen do not always satisfy a man.
It is good if the clinic offers the possibility of donating ejaculate at home in a more comfortable environment, since in a public toilet not every man will be able to concentrate on collecting semen. Therefore, most patients prefer to go to a private medical center with the most convenient amenities and conditions. Before choosing a center, it is better to inquire about diagnostic methods and methods.
The most accurate results after diagnosis can be obtained in the center where manual methods are preferred to automatic analyzers. Many urban clinics still use a microscope to assess semen quality, while modern private centers are equipped with advanced automatic equipment.
For reference! In order to obtain the most accurate spermogram indicators, experts recommend being examined simultaneously in two or more institutions.
How to prepare?
An important condition for obtaining correct analysis results is proper preparation for a spermogram.
Experts put forward several rules of preparation:
- for several days before the analysis, you should avoid thermal procedures such as saunas and baths, solariums, hot showers and sun tanning;
- for several days before the examination, the man should abstain from alcohol, caffeinated drinks and medications;
- From 2 to 7 days before the spermogram, you should avoid sexual intercourse with your partner.
If you need to repeat the test, you should not contact another clinic. At the same time, repeated donation of ejaculate requires the same preparation measures. Only if all points are observed can an objective assessment of the seed by specialists be ensured.
How to submit?
After all the preparation rules have been followed, the man can take the test at the clinic of his choice.
WHO regulates such measures before taking a spermogram:
- First a man must empty his bladder, then wash your hands and your genitals thoroughly with soap.
- To collect semen, the specialist gives the patient a specialized sterile and disposable container, the volume of which is approximately 50 ml.
If previously boiled glass containers were used to collect sperm, today their effectiveness has been refuted. Modern clinics and private centers use 50 ml plastic jars with a lid, which are sterile and for one-time use only. You need to remove the lid only when ejaculation occurs, so that germs and bacteria from the outside do not penetrate inside the container.
If the collection of semen is not carried out in the clinic itself, then the container with the contents must be delivered to the laboratory assistant in a special container that maintains the desired air temperature. You only need to hand over fresh material, that is, no later than 1 hour after collection. But transportation conditions most often reduce the percentage of analysis accuracy, so most clinics involve donating semen within their own walls.
In order to obtain semen, a man must masturbate. Other methods of obtaining sperm, such as collecting semen in a condom after intercourse or coitus interruptus, significantly reduce the accuracy of the analysis. How to improve the quality of semen? To do this, experts advise collecting all the sperm after masturbation without minimal loss, but The first ejaculate is considered the most important.
What is the price?
If the data obtained after the analysis do not correspond to the norm, the specialist prescribes a repeat analysis for the man. There should be 2 weeks between the first and second examination. And a corresponding worrying issue for a man will be the cost of the analysis, since many private centers charge a decent amount for the tests. A good spermogram in any clinic is not included in the list of free procedures provided.
In Russia, Ukraine and nearby countries, examination of a man's semen is carried out for a fee. But no one can give exact numbers, since everything depends on the clinic itself and its pricing policy, the region in which it is located, as well as the type of spermogram methods.
Spermograms are:
- Standard procedure or basic, as a result of which the quantitative, qualitative and morphological parameters of the ejaculate are assessed. The cost of such an analysis can be 500-1000 rubles.
- Extended examination (spermogram according to Kruger), which includes basic assessments as well as complete semen biochemistry and a search for antisperm bodies. The price of such an analysis is 1000-2000 rubles.
In general, a comprehensive examination of a man’s semen involves costs of 2000-2500 rubles, an amount not so high as to verify the man’s reproductive ability and the possibility of conceiving a child.
How to improve spermogram?
To improve spermogram data, you should adhere to the following rules from specialists:
- carrying out therapy with comprehensive programs that include basic and stimulating drugs;
- therapy is carried out for a long time due to the fact that the maturation period of sperm is 70 days;
- semen can be submitted for analysis only 30 days after therapy;
- In general, the course of treatment will last about six months.
For men who have been able to improve the quality of their semen, but are not yet planning to have a child, experts recommend donating sperm to a cryobank, where the semen can be frozen until conception.
Analysis transcript
Decoding the spermogram evaluates the indicators, which can be several dozen. For example, the smell and color of the ejaculate, pH level, viscosity, shade and liquefaction time, microflora and much more. But the main parameters for deciphering the analysis are considered to be the mobility of the seed, the concentration in the entire sample and in 1 ml of ejaculate, as well as morphological characteristics.
Over time, the “stringency” of WHO requirements regarding sperm fertility gradually began to decrease. So, for example, back in 1999 the volume norm was 2 ml, and at the time of 2010 it was only 1.5 ml. Also, morphological indicators decreased from 30% to 4%, the percentage of motility became 10% lower, and the number of sperm fell from 40 to 39 million per 1 ml.
Causes of sperm deterioration
To improve the quality of a man’s ejaculate, thereby increasing his reproductive abilities, one should not only undergo an examination and a course of therapy, but also eradicate the causes of this phenomenon.
Reasons for low ejaculate quality:
- frequent consumption of alcoholic beverages;
- smoking;
- narcotic substances;
- poor nutrition, excess weight;
- use of anabolic steroids;
- excessive force loads;
- frequent overheating of the penis;
- unfavorable living and professional conditions.
If the causes have not been eliminated, most likely, a course of therapy will give temporary results. But if the improved sperm is frozen, it is possible to conceive a child in the laboratory at the right time.
Spermogram – (sperm + Greek gramma – record; synonym – spermatogram), a complete detailed analysis of sperm (physical properties, chemical and cellular composition, etc.), which makes it possible to assess a man’s ability to fertilize.
The spermogram characteristics include the following indicators (minimum values are given according to the latest WHO standards from 2010):
- ejaculate quantity - 1.5-6 ml
- color - milky white
- smell - chestnut
- pH - 7.2-7.4
- liquefaction time - 20-30 min
- viscosity - 0-5 mm
- number of sperm in 1 ml - more than 15 million/ml
- the number of sperm in the entire ejaculate is more than 39 million
- mobile - more than 40%
- actively mobile - more than 32%
- number of live sperm - more than 58%
- normal forms - more than 4%
- leukocytes - up to 10 per field of view
- red blood cells - no
- epithelium - 2-3
- Bechter crystals - single
- lecithin grains - a lot
- mucus - no
- spermagglutination - no
- microflora - no
- special resistance tests - 120 min or more
- sperm movement speed - 3 mm/min
- metabolic activity - 60 min or more
- fatigue - the percentage of mobile forms after 1 hour decreases by 10%,
after 5 hours – by 40%
It should be noted that a deviation from these characteristics in one direction or another is not always a sign of a disease. Only a comprehensive assessment of the data obtained and their relationships allows us to assess the fertilizing ability of a man. At the same time, a spermogram can not only be used to identify infertility, but also makes it possible to evaluate other pathological abnormalities in a man’s health.
For example, an increased level of white blood cells may indicate the presence of inflammatory processes. Not only in the reproductive system, but throughout the entire body. But it must be remembered that the content of leukocytes in the blood is not constant, but can vary depending on the time of day and the functional state of the body. The number of white blood cells may increase after eating, especially high-protein foods (food leukocytosis), as well as after physical and emotional stress. According to WHO standards, a quantity of no more than 1 million leukocytes per ml is considered acceptable. If there are a lot of leukocytes, a man should pay attention to his lifestyle.
Rules for taking the analysis
To submit sperm for analysis, a man must fulfill some simple requirements. It is necessary to completely abstain from sexual activity for at least 3-4 days, but no more than a week. On days of abstinence, you should not drink alcohol (even beer), take medications, take a steam bath, or take a bath (preferably wash in the shower). It is better to obtain sperm in the laboratory through masturbation or interrupted coitus. You cannot receive sperm in a condom, since from contact with the rubber and substances with which the condom is treated, sperm lose their mobility after 15-20 minutes. It is best to donate sperm for analysis in the same room where the laboratory is located. Cooling sperm leads to distortion of its parameters. The optimal temperature to prevent sperm from dying is 20-37°C. It is very important that all the sperm ejected during ejaculation completely ends up in laboratory glassware. The loss of even one portion (especially the first) can significantly distort the result of the study. Fulfilling all these requirements will help to avoid errors in spermogram indicators. This is especially important when assessing sperm in men with insufficient spermatogenesis and the elderly. If the sperm count is high, then you can limit yourself to one analysis. If there are pathological changes in the ejaculate, 2 or 3 times analysis is required at intervals of a week.
It is important to remember that a man's potency is not an indicator of his fertility, i.e. ability to bear children. Often a woman’s confidence in her husband’s good reproductive function is based only on a high assessment of his sexual potency. However, extremely low potency is often combined with excellent sperm fertility, and vice versa - the owner of sperm without sperm can have high potency. Usually it is very difficult to force this category of men to take a sperm test, especially with a short history of infertile marriage. It is necessary to show firmness, supported by knowledge of what has just been said.
It is also impossible to judge the ability to bear children and male qualities by the volume of semen. As practice shows, a large volume of sperm does not mean its higher fertilizing ability. In general, the fertilizing ability of sperm is characterized not so much by its volume, but by the number of sperm in the ejaculate, which for a successful pregnancy must be at least 39 million (according to WHO). In this case, motile sperm should make up at least 40% of their total number.
Before ejaculation, a small drop of fluid (pre-ejaculate) wets the end of the penis. It comes from the Cooper's gland and is highly alkaline, neutralizing all traces of acid after urination. It cleans and rinses the urethra, preparing it for the passage of sperm. This fluid contains several thousand sperm. There is a theory according to which these are the highest quality sperm. Because of this drop, the practice of contraception using “coitus interruptus” often does not give the entirely expected result.
Although prolonged abstinence increases the number of spermatozoa in semen, their fertilizing ability decreases.
An oily and sticky environment reduces sperm motility; acid and salt kill them.
A spermogram is a test often used in urological practice, which allows one to determine a man’s ability to conceive based on the composition of sperm and to suspect certain diseases of the genitourinary system. How is the analysis collected and what results can be obtained?
It's not scary
What is it?
Analysis room
On the appointed day, the man comes to the laboratory and goes through the registration procedure with the medical staff. The nurse provides a container for biological fluid - a special sterile container with a lid. The man washes his hands, washes himself and retires to a special room, in which, if possible, suitable conditions have been created for taking a spermogram - nothing medical, soft sofas, erotic magazines.
Through masturbation, the patient receives sperm - and all of it, from the first to the last drop, must be caught in a container. The closed jar must be given to the laboratory assistant. The study of the obtained material begins immediately, since the properties of sperm change over time. The analysis result will be ready on the same or the next day.
Biomaterial for is collected in a similar way. This test allows you to clarify the causative agent of the infection and its susceptibility to antimicrobial drugs. Sowing takes 3-7 days.
3 most frequently asked questions about the procedure
Is it possible to collect material at home?
Conversation with the doctor Some laboratories allow collection of sperm at home, but then the jar with the contents must be delivered to the laboratory assistant within 40-60 minutes after ejaculation, otherwise the test result is unreliable. It is advisable to use sterile pharmacy containers for testing. During transportation, the sample cannot be overheated or overcooled: the temperature should be within 20-37C, that is, from room temperature to body temperature.
Is it possible to collect the material in a condom and then transfer it to a container?
No, because when sperm comes into contact with latex and the “lubricant” of the condom, a chemical reaction occurs and the test results are distorted.
Is it possible to collect material through interrupted sexual intercourse?
No, because components of the partner’s vaginal secretions may get into the biological material. There is also a risk of losing the first drops of ejaculate.
Preparing for the test
What needs to be done to ensure that the results are as reliable as possible and that the test does not have to be repeated due to defects in the collection of biomaterial?
Rejection of bad habits
- Avoid any sexual contact 3-4 days before the test. If abstinence is less than 3 days, the amount of ejaculate is not enough for diagnosis, and if more than 7 days, there will be a lot of abnormal sperm in the sample.
- During the period of abstinence before the test, any alcoholic beverages are prohibited. Tobacco smoking, excessive physical activity, and psycho-emotional stress also negatively affect the results of the analysis.
- If you are taking any medications regularly, tell your doctor. If possible, they should also be abandoned on the eve of the examination.
- You cannot visit the bathhouse, sauna, or sunbathe. Replace the bath with a hygienic shower.
- Do not take a spermogram against the background of ARVI, intestinal disorder or other acute infectious diseases.
- You cannot collect material directly after prostate massage.
As a rule, diagnosis requires 2-3 repetitions of the spermogram with an interval of 2-4 weeks between samples. After a course of treatment for prostatitis, a follow-up examination is also required. If deviations from the norm are found in at least one sample, the rules for taking a spermogram must be strictly observed.
Indications for the test
A spermogram is prescribed in the following cases:
- examination of an infertile couple;
- suspicion of prostatitis, prostate adenoma;
- suspicion of diseases of the testicles, seminal vesicles;
- sperm donation planning;
- sperm conservation planning;
- preparation for assisted fertilization technologies - IVF and ICSI.
Analysis results
More than 50 characteristics can be determined from a semen sample. Here are the most important ones:
Research Analysis - amount of ejaculate;
- color;
- smell;
- acidity;
- liquefaction time;
- viscosity;
- the number of sperm in the entire ejaculate and in 1 ml;
- determination of the proportion of mobile, living and anatomically normal forms;
- the presence of leukocytes, erythrocytes, prostate epithelial cells, bacteria, mucus in the ejaculate;
- the presence of amyloid bodies;
- assessment of agglutination (sticking).
Most of these parameters are used to diagnose male infertility. It is impossible to establish a diagnosis of prostatitis from one spermogram - only to see signs of inflammation in the genitourinary system and refer the patient for further examination.
Analysis of urine - urine tests - general, three-glass test, etc.;
- general and biochemical blood tests;
- smear from the lumen of the urethra;
- PCR diagnostics of sexually transmitted infections;
- transrectal ultrasound (TRUS);
- cystoscopy;
- computed tomography (CT), etc.
Spermogram and prostatitis
The prostate gland produces a special secretion that facilitates the sliding of sperm and urine through the urethra. It has an alkaline reaction, which allows you to neutralize the acidity of urine and keep the germ cells in the sperm intact and unharmed. More than half of the ejaculate consists of this liquid. That is why with prostatitis there is a decrease in the amount of sperm up to a dry orgasm and male infertility appears in the very early stages.
What changes in sperm should push a man to the urologist’s office?
Conversation with the doctor - or orgasm during intimacy.
- The sperm changes its milky white color to yellow, greenish, pink or brown.
- The ejaculate has an unpleasant odor.
- Sperm is absolutely transparent or, on the contrary, it contains clots like lumps in semolina or threads.
What changes in the spermogram are typical for inflammation in the prostate gland?
Pyospermia – “pus in semen” – detection of more than 1 million leukocytes in 1 ml in a sample.
Bacteriospermia is the presence of more than 103 CFU in 1 ml of microorganisms in a sample. Both of these deviations can also be detected in orchitis, vesiculitis, urethritis, etc.
Hemospermia is an impurity.
Distinguish between true and false. With false hemospermia, an admixture of fresh blood obtained from microtrauma during sexual intercourse is detected in the biomaterial. The sperm portion has a pink tint. The causes of true hemospermia are inflammatory and oncological diseases of the genitourinary system. In this case, the sample is colored brown, chocolate.
Asthenozoospermia – sperm immobility. It occurs as a result of chronic inflammation caused by exposure to toxic (alcohol, tobacco, occupational hazards) or infectious factors. The most common cause is chronic prostatitis.
Oligozoospermia is an insufficient number of sperm in the ejaculate, less than 20 million per 1 ml.
Teratozoospermia is an excess of anatomically defective germ cells incapable of fertilizing an egg.
Only a doctor will give a detailed conclusion on the test results.
The need to take a spermogram can be psychologically stressful for men. However, this simple and very informative examination allows for early detection of many pathologies of the intimate sphere and excretory system. Early diagnosis is the key to successfully solving health problems.