Analysis of sperm ( ejaculate ) .Semen - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | The Andrology

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Spermogram - ejaculate research method to assess the ability of male sperm oplodotovoryayuschey.Semen analysis shows the quantitative, qualitative, morphological sperm parameters.

sperm analysis is carried out in the case of:

  1. infertile marriages (identifying male factor, semen - male infertility).It called barren marriage, in which a pregnancy does not occur within 1 year of regular sexual intercourse without contraception.
  2. Infertility in men (prostatitis, varicocele, infection, trauma, hormonal disorders).
  3. Preparation for artificial insemination.
  4. planning to become pregnant.
  5. desires men to check their fertility (fertility).

How shall semen?

Material for research is collected by masturbation.You can bring the ejaculate in a sterile, hermetically sealed container, warm (in pomyshechnoy depression or incubator at body temperature), within an hour after the testing.Before putting abstinence analysis of at least 4

days but no longer than a week.In this period the rejection of thermal treatments of alcohol.After antibiotics should be at least 2 weeks.
Methods sperm study: phase-contrast microscopy, special staining for evaluation of sperm morphology.

Norma semen

• Volume - 2 ml;
• Consistency - sticky;
• Dilution in 10-30 minutes;
• Viscosity up to 2 cm;
• Color - white and gray;
• Smell - specific;
• pH 7.2-8.0;
• Turbidity - cloudy;
• Mucus - is absent;
• The number of spermatozoa in 1 ml - 20 mln.- 200 million .;
• The total number of sperm in the ejaculate - more than 40 million .;
• The number of active spermatozoa - more than 25%;
• The total number of aktivnopodvizhnyh and inactive - more than 50%;Fixed sperm
• - less than 50%;
• Lack of agglutination and aggregation;
• The number of white blood cells to 1 million;
• Normal sperm - more than 50%;
• Sperm with normal morphology of the head - more than 30%;
• The cells of spermatogenesis - 2-4.

Explanation sperm, classification indices ejaculate:

• spermatoschesis - absence of ejaculate,
• oligozoospermia - reducing the number of sperm in the ejaculate (less than 20 million per 1 mL),
• azoospermia - no sperm in the ejaculate,
• kriptozoospermiya - the presence of individualsperm in the ejaculate after centrifugation,
• asthenozoospermia - decrease sperm motility,
• theratozoospermia - reduction of normal sperm morphology.

results semen

When the results different from the norm, you need 1-2 weeks to hand over sperm again and with the results to see a doctor-andrologist to find the cause of the pathology.An exception is suspected genital infections, in this case the treatment must start immediately.For example, the impact of prostatitis on spermogrammu manifested in sperm motility.Great influence on the quality of sperm have a infectious prostatitis (especially caused by infections, sexually transmitted diseases).Inflammation in the prostate reduces sperm motility, promotes their agglutination (bonding because of the presence on the surface of sperm bacterial bodies or their metabolic products) and the formation of defective forms (for example, poor semen as a result ureaplasmosis).

How to improve semen analysis?

Sometimes you can improve sperm quality by eliminating industrial and household hazards, establish a normal rhythm of work and rest, you also need to provide good nutrition, regular rhythm of sexual life.It is useful on a daily basis to engage in physical exercises with an emphasis on exercise, improve pelvic and abdominal muscles.

most effective for improving the quality of semen is the treatment of urological, endocrine diseases, as well as the use of certain medicinal products.What drugs and the duration of their admission prescribed by the doctor urologist-andrologist.

condition of spermatogenesis measured at spermogramme (spermiogram).

For spermiologicheskogo correct diagnosis at the time of the ejaculate is necessary to observe the following conditions:

  • abstinence from ejaculation for 2-7 days (the optimal duration of 4 days);
  • abstinence from alcoholic beverages, including beer, potent drugs (hypnotics and sedatives) during that period;
  • refraining from visiting saunas and hot tubs from the reception 2-7 days;

Often patients report spermiologichesky andrology diagnosis and issue at hand spermogrammu without a detailed explanation.Patients are a lot of questions: Which of the indicators is not correct, which means that this discrepancy is linked indicators of semen?

We have tried to create for you a table of basic semen parameters with brief comments.The table shows the rate of spermiologicheskih WHO indicators (4th edition, Cambridge University Press, 1999 (MEDpress, 2001)), as well as the recommended norm.

We hope that this table will help you to better navigate the semen analysis, but note that the results of semen evaluated comprehensively and correctly interpret them can only be a professional.

of semen, their norms and comment deviations:

of semen What does indicator Standards WHO Comment
recommends-emye our standards
term abstinence number of days of abstinence prior to analysis 2-7 days Failure to comply with the terms of abstinence analysis result can not be compared with the standard and spermiologichesky diagnosis in this case should be considered invalid.The average period of abstinence are optimal for the study of the ejaculate.Re-analysis should take with the same period of abstinence that first.

3-5 days is optimal - 4 days
volume total volume of ejaculate. 2 ml and more ejaculate volume less than 2 ml qualifies as mikrospermiya, which in most cases is associated with poor function of accessory genital glands *.The upper limit of the volume of the ejaculate is not limited to the WHO Guidelines.However, according to our observations, the increase in ejaculate volume of more than 5 ml.often it refers to inflammation of the paranasal gonads.

3-5 ml
Color Color ejaculate. Greyish red or brown color indicates the presence of blood, which can be caused by the presence of tumors, stones in the prostate gland, or trauma.The yellowish tint may be a variant of norm or indicative of disease jaundice or taking certain vitamins.

White, gray or yellowish
PH ratio of positive and negative ions. 7,2 and more WHO experts is limited only by the lower pH.However, according to our observations, not only to reduce the pH below 7.2, but its increase above 7.8 in most cases indicates the presence of inflammation in the accessory genital glands.

7,2-7,8 ​​
Time liquefaction sperm liquefaction time to viscosity standards. to 60 min Longer thinners is usually a consequence of long-term current paranasal inflammations in the gonads such as the prostate (prostatitis), seminal vesicles (vesicles) or enzyme deficiency.We believe the time thinning one of the most important indicators spermiologicheskih.It is important that the sperm as quickly as possible given the opportunity of active movement.With prolonged liquefaction, sperm moving in a viscous medium, quickly lose biologically available energy (ATP), are longer in the vagina acidic environment which significantly reduces their mobility and, consequently, their ability to fertilize.

60 minutes
viscosity (consistency) viscosity of the ejaculate.It measured in centimeters thread in which it is formed and separated from a drop pipette or special needle. small individual drops (2 cm.) reasons for increasing the viscosity of the same as the time increases liquefaction.The WHO Guidelines are no clear standards for semen viscosity.Saying only that: "In a normal ejaculate, emerging from the pipette, forms small individual droplets, and the sample with pathological forms a thread viscosity greater than 2 cm."We believe that the drop of a normal liquefied semen must not extend more than 0.5 cm., Since according to our observations fertility patients, sperm viscosity greater than 0.5 cm., And the more than 2 cm., Is significantly reduced.

0,1-0,5 cm
sperm density number of spermatozoa in 1 ml.ejaculate. 20 million. More

increase or decrease in sperm density is defined as polizoospermiya or oligozoospermia, respectively.The upper limit of normal sperm density index of WHO experts is not limited.However, according to our observations, the increase in sperm density above 120 mln. / Ml in the majority of cases, combined with their low fertility and ability in many patients subsequently replaced oligozoospermia.Therefore, we are convinced that with polizoospermiey patients need follow-up.Reasons for change in sperm density is not fully understood.It is believed that they are the result of endocrine disorders, blood disorders in the scrotum, or the toxic effects of radiation on the testicle (spermatogenesis enhancing or depressing), inflammation and rarely - violations of immunity.

20-120 million.
Total sperm sperm density multiplied by the volume. 40 million. More possible reasons of non-compliance are the same as in the previous paragraph.
From 40 to 600 million.
Sperm Motility mobility.
Evaluated by 4 major groups:
1. Active-moving with rectilinear motion (A)
2. slow-moving-WIDE rectilinear motion (B)
3. slow-moving-nye with the vibrational or rotational motion (C)
4. Fixed (D)

type A & gt;25%,
or A + B & gt;50%
60 min.after ejaculation

Reduced sperm motility called asthenozoospermia.Causes asthenozoospermia not completely clear.It is known that asthenozoospermia may be a consequence of radiation or toxic effects, inflammatory or immunological factors.Also, matters and environmental conditions.Asthenozoospermia often seen in people working at an elevated temperature (cook, attendant, employee of "hot shop", etc.).
type A & gt;50%,
type B - 10-20%
type C - 10-20%
type D - 10-20%
after 60 minutes.after ejaculation
Morphology content of the ejaculate sperm with normal structure and capable of fertilization. More than 15%

There is no consensus of experts as a matter of evaluating the morphology of sperm, and on the content of normative values ​​of normal sperm in the ejaculate.Therefore, evaluation of sperm morphology - one of the most subjective and controversial topics in spermiologicheskom study.Typically morphologically normal sperm cells constitute 40-60%.In Russia, the diagnosis teratospermia, ie"Ugly sperm," put in those cases when the number of sperm with normal structure is less than 20%.The worsening morphological indicators often transient and occurs with stress, toxic effects, and others. Also, the morphological pattern of the ejaculate is largely dependent on the environmental situation in the region of the patient's residence.As a rule, the number of pathological forms is increasing among residents of industrial areas.

More than 20%
Live sperm (sometimes - dead sperm) Content of live sperm in the ejaculate as a percentage. More than 50%

content of the ejaculate more than 50% dead sperm called nekrospermiey.Nekrospermiya, as well as the deterioration of the morphology, often of a temporary nature.Possible causes nekrospermii -. Poisoning, infection, stress, and other long-existing nekrospermiya evidence of severe disorders of spermatogenesis.

More than 50%
spermatogenesis cells (immature germ cells) spermatogenesis cells - are cells of the epithelium of the seminiferous tubules of the testicle. Interest norms no encountered in each ejaculate.A significant number of the number of germ cells (epithelial desquamation), occurs in the secretory form of infertility.

Up to 2%
sperm agglutination

agglutination of sperm - sperm is bonding with each other, which prevents their forward movement.

Normally there should be no

true agglutination is rare and indicates irregularities in the immune system.It is necessary to distinguish the true from the sperm agglutination aggregation.In contrast to the aggregates, while only true glued sperm agglutination and "outlet" are not contain cellular elements.
Normally there should be no
leukocytes White blood cells.There always.

1 * 106 (3-4 in the standard field of view)

Exceeding standards indicates the presence of inflammation in the genitals (prostatitis, vesicles, orchitis, urethritis, etc.).
1 * 106 (3-4 in the standard field of view)
Erythrocytes Red blood cells.

Normally there should be no

presence of red blood cells in the semen may be associated with tumors, traumas of the genitals, the presence of stones in the prostate, vesiculitis.Alarming symptom that requires serious attention!

Normally there should be no
Amyloid corpuscles

formed as a result of stagnation of prostate secretion in its various sections.The amount is not counted.

WHO Standards no

referred to as "presence / absence of (+/-)".Amyloid corpuscles are not currently available in many patients, which suggests some reduction of the prostate gland.
Standards no
Lecithin seeds

is produced by the prostate gland.The amount is not counted.

WHO Standards no

referred to as "presence / absence of (+/-)".A small amount of lecithin granules shows a decline in prostate functions.
Standards no
Slime contained in the ejaculate mucus.

WHO Standards no

may be present in the norm.Large amounts of mucus indicates possible inflammation of the paranasal gonads.
Standards no

* K accessory genital glands are prostate, seminal vesicles, Cowper's glands, and others.

Standards of semen referred to in WHO guidelines and recommended us, in some cases different.

's try to argue our position.