Spermiogram

What is a Spermiogram?

Spermiogram is the first and probably the most important test to evaluate male fertility, by checking quantitative sperm traits (e.g. total sperm count, sperm volume etc), qualitative sperm traits (e.g. sperm morphology, sperm motility etc)   and other parameters (e.g. sperm agglutination, white blood cell count etc) Semen is defined as the whitish viscous fluid emitted from the urethra during ejaculation, containing sperm cells and seminal fluid.

When is a Spermiogram performed?

A Spermiogram is conducted:

  • to investigate the fertility of a couple who want to conceive.
  • within the context of sperm retrieval and cryopreservation for future use.
  • within the context of Assisted Reproduction, in couples who are unable to conceive naturally. 
  • following surgical operations or therapeutic regimens that may affect testicular function.
  • following ligation of the ductus deferens, so as to identify absence of sperm cells in the man's semen.

What preparation is needed for a Spermiogram?

To get reliable results, the man should refrain from ejaculating for at least 2 days before the Spermiogram, but not for more than 7 days. In addition, the man should not have presented high fever (>39οC) during the last three months at least, and should not have taken medication or other substances that might occasionally harm sperm cells. In these cases, the man has to inform his physician, so as to get instructions required.

How is a Spermiogram performed?

The semen sample that is collected through masturbation in a room next to the laboratory has poorer qualitative and quantitative features than the semen sample collected by the man into a condom (not containing spermicide substances) at home following sexual intercourse.

In every case, the semen sample has to be exposed as little as possible to atmospheric conditions. While collecting the sample, the man should be very cautious to collect the entire amount of  seminal fluid.  For the first drops of seminal fluid contain the highest number of emitted sperm cells, whereas the last drops contain substances that are significant for evaluating other sperm parameters, such as viscosity, acidity etc.  The semen sample has to be taken to the laboratory in a special sterile collecting container within 20-30 minutes. The specimen should be retained warm when transferred to the lab (20-37οC). An effective way to do so is keeping it under your armpit until reaching the lab.

More than one semen samples are required to ensure that male fertility testing is reliable and sufficiently documented. Semen specimens (2 or 3) have to be collected within a time distance 3 to 4 weeks one from another.

How are the results of a Spermiogram interpreted?

According to the Spermiogram analysis results, the following conditions may be detected:

  • Aspermia: complete lack of semen after ejaculation.
  • Azoospermia: absence of sperm cells in the semen sample.
  • Cryptoazoospermia: presence of very few sperm cells in the ejaculate but only after centrifugation of  the sample.
  • Hypospermia: small sperm volume.
  • Oligospermia: Low spermount (<15Χ106 sperm cells/ml or <39Χ106 sperm cells in total, according to the latest WHO Guidelines 2010). 
  • Asthenospermia: reduced sperm motility (<32% rapid progressive motility, according to the latest WHO Guidelines 2010)
  • Teratospermia  High number of sperm cells with abnormal morphology (<4% sperm cells with normal form, according to the latest WHO Guidelines 2010).
  • Necrospermia: presence of only dead sperm cells in the sample.

Other equally important results are:

  • Acidity (pH): ≥7.2
  • White blood cells: 1Χ106
  • Sperm agglutination (sperms that clump or stick together) <50%