Spermogram
Method is based on the macroscopic and microscopic examination of sperm according to recommendations of the WHO. Macroscopically the colour, volume, liquefaction, consistence, pH level of the sperm is evaluated. Microscopically the concentration of spermatozoa, count of spermatozoa in ejaculate, motility, agglutination and morphology of sperm, as well as presence of other cells in the ejaculate is evaluated.Macroscopic and Microscopic parameters:
Volume of spermatozoa (amount)
Norm is 1.5-6 ml but if lower than 1.5 ml, reduced (oligozoospermia) or increased if larger than 8 ml (polyspermia).
Colour greyish, opalescent in colour.
Any changes can indicate malfunction of urinary-genital tract (for example, transparent – oligozoospermia or azoospermia, or retrograde ejaculation; reddish or brownish – presence of erythrocytes, including bleeding or increased permeability of the walls of ducts; muddy, heterogeneous – agglutination or aggregation, presence of micro flora. Approved microscopically)
Sperm PH level
Standard 7.2-8.0 slightly alkaline environment
Lower than 7.2 – acidic environment, possible dysfunction of the seminal vesicles.
Higher than 8.0 – highly alkaline environment, suspicions of prostate dysfunction (inflammation, especially indicated if leucocytes or chronic inflammation cells are discovered).
Liquefaction
Standard if the sperm liquefies within 1 hour. If longer or it does not liquefy at all, we can suspect possible prostate dysfunction.
Consistence
In standard dropping by drops from dropper. If mucous, viscous we can suspect possible prostate dysfunction.
Concentration
In standard above 15*106/ml. If lower - oligozoospermia. If not present - azoospermia.
Total count
Concentration is multiplied by the quantity, in standard above 39 million in ejaculate. It is important to hand over entire amount of ejaculate in the container. If the total amount is smaller - oligozoospermia, the chances of in vivo (natural) fertilization is reduced.
Motility
Active A+B above 32%. If less – asthenozoospermia, in vivo fertilization chances are reduced. Motile A+B+C above 40%. If less than 90%, it can indicate necrozoospermia (for example, due to varicocele), it is necessary to perform evaluation of the vitality of spermatozoa and eosin nigrosine stain test, or HOS test.
Agglutination
Without a standard norm. If present, size of clusters should be evaluated, percentages of agglutinated spermatozoa, sometimes agglutination areas can be expressively differentiated (heads, tails, necks).
Aggregation
Without a standard norm. If present, size of clusters should be evaluated, other cells (usually, squamous epithelium), micro flora, traces of mucous, aggregation takes place with.
Morphology
In standard >4% standard forms. If below 4% - teratozoospermia.
Evaluates separately number of pathologies in heads, necks, tails out of which the teratozoospermia index (TZI) is calculated: in standard <1.60. If TZI above 1.60, in vivo fertilization chances are reduced.
If increased number of cytoplasm drops or immature shapes, suspicion of spermatogenesis disturbances.
„Round” cells can be of various forms:
- Leucocytes: without a standard norm. If above 1 *106/ml – suspicion of acute inflammation, if below 1 mlj/ ml – sub-acute or chronic inflammation
- Chronic inflammation cells (lymphocytes, monocytes, macrophages): without a standard norm. If above 1*106/ml – acute chronic inflammation suspected, if below 1*106/ml – chronic
- Spermatogenesis cells (spermatids ”shadow” cells, rarer – spermatocytes): standard up to 5*106/ml. If above 5*106/ml, disturbances of spermatogenesis are suspected
- Squamous epithelium cells. Usually non-existent or rarely present. Increased number causes suspicions about incorrect collection of sample (due to sexual intercourse not masturbation)
Glandulous epithelium cells: usually non-existent or rarely present. Increased number can show inclinations towards destructive processes in the urogenital ducts.
All spermogram parameters should be analyzed together, in considering also the age and general health condition of the patient. Doctor-urologist can provide interpretation of received data from the performed spermogram.
