Spermogram – sperm analysis is the first step to diagnose male infertility. Furthermore disorders shown at the spermogram may also be an evidence of various infections or prostatitis. Spermogram analysis is quite simple and everyday research method nowadays.
Semen analysis is an integral part of the workup of couples consulting for infertility. The availability of semen renders possible direct examination of male germ cells, giving precious data that are not accessible for female germ cells.Altogether these data give indications on the testicular function and of the integrity of the male genital tract.
It should be emphasized that semen is an exception amongst biological fluids since its parameters display very wide intra and inter-individual variations. Therefore semen analysis should be repeated to take intra-individual variations over time into account and confirm abnormal parameters.The major part of the ejaculate volume is contributed by secretions from the accessory glands (seminal vesicles and prostate), so the ejaculate volume is not directly related to spermatogenesis and hence the sperm cell concentration (sperm cells/ml) varies according to the ejaculate volume. The total number of spermatozoa per ejaculate reflects the spermatogenesis and is related to the time of sexual abstinence before collection. In normal situation spermatogenesis is considered to be a constant process over time and therefore the total number of sperm per ejaculate should increase with abstinence time. The ejaculate volume is related to the secretory function of the seminal vesicles and prostate. Decreased ejaculate volume and increased sperm concentration reflects impaired accessory glands function.
The correct way of providing spermogram
Sperm analysis should be given in 3-4 days of continence. The alcohol intake is also not advised within these days. The alcohol contributes to decrease of the sperm quality.
The ejaculate gather should be made in special hospital room which interior has to differ from the hospital one. Sometimes it is allowed to gather sperm at home. However in this case it should be carried to the laboratory within one hour in special container. Anyway the advantage of gathering sperm in the hospital is the ability to check it straight after its dilution.
Sperm always contain spermatozoa of all movement categories.
There are many factors affecting spermatozoa mobility. The increased white blood cells may be a feature of male urogenital system inflammations.We also should consider that spermogram and its figures are quite variable. It is advised to get spermogram analysis twice with 2 weeks interval.
The fraction of motile sperm in semen is measured either by manual counting or using a computer assisted semen analysis (CASA) system. Motility is assessed at the time of semen liquefaction and after 1 hours to detect asthenozoospermia. Manual counting classifies sperm cells into 4 categories (immotile, locally motile, non linear and linear motile) using qualitative subjective criteria of selection.
Direct measurement of infectious contamination is obtained from bacteriological cultures of both aerobic and anaerobic germs. In normal conditions semen is not sterile but rather colonized at low levels by a variety of germs.
Swim Up Technique
The swim up technique is rapidly becoming more and more popular throughout fertility clinics. This technique revolves around the fact that sperm need to swim forwards and up in order to reach the uterus. Only the most powerful sperm will be able to do this. In order to retrieve this powerful sperm, semen is placed in a culture dish with a layer of media culture. Sperm are attracted to this culture, and will swim up to it. As the sperm swim up to the culture, they are collected. This technique takes about two hours in order to harvest enough sperm for use in IUI.