Semen analysis

IVF Laboratory / Semen analysis

Semen analysis (spermograme) is a lab procedure which establishes the possible causes for male infertility.

OminiClinic experience shows that male infertility or sub fertility cases are roughly as present as female infertility or sub fertility ones (approximate 50%).

Semen is a viscous substance composed from spermatozoa produced by testicles and seminal liquid, the nutrient environment of the spermatozoa, and it is formed from 2/3 the secretions of seminal vesicle and 1/3 the secretions of prostate. The liquid produced by seminal vesicle has a viscous consistency, rich fructose content and an alkaline pH (basic). The liquid produced by prostate has an acid pH, contains citric acid, a number of phosphatase acid like enzymes and zinc. Due to prostate produced enzymes, the semen is liquefied in 10-30 minutes at room temperature.

The basic functions of the prostate are nutrition and transport of spermatozoa, as well as increasing the pH from the vagina over the 6.2 value, the value from which the spermatozoa keep themselves mobile.

The volume and physico-chemical properties

The majority of men produce between 2 and 6 ml of semen. A low volume of the ejaculated liquid will have an insufficient capacity to neutralize the vaginal pH, and high volume will result in a low spermatozoa concentration. A low volume of semen could indicate:

- a blockage of seminal vesicle or of ejaculatory duct.

- retrograde ejaculation, in which a part or all of the semen is released in urinary bladder

- infection

- hormone imbalance

The normal aspect of semen is yellowish-white, opaque or a bit translucid. An intense yellow, brownish, reddish, greenish semen, too viscous, too fluid or with an intense smell, indicates some pathological problems that can have impact on fertility.

Concentration or number of spermatozoa in the semen

It is an important parameter for fertility. According to the latest recommendations of the World Health Organization (WHO) , the lower normal of semen concentration is 15 millions per milliliter (mil/ml). A concentration of under 15 mil/ml is define as oligozoospermia and can occur due to :

- stress

- smoking

- side effects caused by some medicines or drug abuse

- malnutrition

- hormone imbalance

- varicocele

- - consequences of testicular traumas or local surgery

- Y chromosome defects

Spermatozoa motility

According to WHO, a minimum of 50% mobile spermatozoa from the total amount of spermatozoa is a criterion of normality, although this parameter is closely related to spermatozoa concentration in the semen. At a higher concentration from the normal limit, a lower percent ( down to 25-30%) of mobile spermatozoa can successfully ensure the fertility function, if the motility is situated in the rapid-progressive category. A low motility of spermatozoa is known as asthenozoospermia or necrozoospermia (if the immobility is caused by a reduced viability of the spermatozoa).

Spermatozoa morphology

Abnormal morphology of spermatozoa directly affects their fertilization ability. Abnormal morphology of spermatozoa is known as  teratozoospermia and can be found in various forms (as shown). According to strict criteria for classification, a ratio of at least 4% of sperm with normal shape of the total sperm is associated with normal fertility function.

Determination of the presence of anti-sperm antibodies in the semen

Anti-sperm antibodies present in the semen are IgG of IgA immunoglobulins. These occur in the semen when, due to some obstructions, infections or trauma, the hemato-testicular barrier is affected.

Anti-sperm antibodies tie themselves to the surface of spermatozoa through the specific antigens from their head, intermediate part or tail. In general, the detection of the anti-sperm antibodies in the tail region means that the motility of the spermatozoa is diminished, while their presence in the head regions is associated with the incapacity to fertilize the oocyte.

The presence of 20% -39% of reactive IgG spermatozoa in the semen can be interpreted as a suspicion of immunologic infertility, while at values of over 40% the immunological infertility is very probable.