• It helps to see if the problems regarding infertility are due to the male partner. It should be conducted after a 3-4 days of sexual abstinence. In order not to get incorrect results, sperm sample should be taken to lab in maximum 30 minutes with room temperature or body temperature without exposure to sun. There are special rooms in mst of the centers nowadays for this purpose. First step for the examination of sperm production capacity of male testicles and health condition of male genital system is spermiogram. A certain number of normal and active sperms should be contained in the semen in order for the fertilization to happen.



  • Structure of Sperm Cell

    Sperm cell which is 0.05 mm long consists of three parts: head, neck and tail. Head part contains the genetic material. Neck provides the energy required for movement and the tail ensures sperm activity (mobility). Disorders regarding sperm structure or “morphology” are reasons for infertility.


How are the sperms examined?
Spermiogram (sperm analysis, sperm test, semen test, semen analysis) is a test where number, shape, mobility of sperms are analysed. Sperm number, ratio of normal sperms against abnormal ones, amount of sperms with good mobility are evaluated. Additionally, characteristics of the semen sample obtained from the male such as amount, pH, color, leucocyte containment, fructose amount, liquefaction are evaluated. Periodically, sperm mobility is also analysed. Sperms are classified in accordance with these mobility types.

(Sperm = Ejaculate = Semen = Seed)

Sperm evaluation criteria use various different limits. Kruger vriteria is an evaluation method that emphasizes mostly sperm shape disorders. After a special coloring, sperm shape (morphology) Characteristics are analysed and the fertility capacity of sperm sample is determined. In order to make the correct decision by looking at the sperm analysis results, at least two different sperm samples should be taken. In case of a fertility problem spotted during sperm analysis, physical and hormonal advanced examinations are conducted on the male patient. Sperm production cycle is renewed in every 3 months. This means that a sper produced will be released in the semen in around 3 months.

Similarly, detrimental effects the male has been exposed and the medications used for the treatment can effect the sperm production in 3 months. At the time of sperm analysis result evaluation, this process should be kept in mind.

According to WHO 2010 criteria, normal spermiogram values are listed below:
        
• Appearance and color: Normally homogenous, grey-opaque
• Volume should be more than 1.5 ml
• Liquefaction (Solubility of Semen): Semen which is sitcky during ejaculation should be soluble in 10-20 minutes. A setback as the prolongation of liquefaction time shows an increase in the viscosity of the semen. This reduces the ability to fertilize.
• Viscosity: Normally the semen is mildly viscous. Viscosity increase reduces the ability to fertilize.
 Sperm concentration should be over 15 million/ml
• Total sperm number should be over 39 million
• Ph should be over 7.2
• Total motility: should be over 40%
• Progressive motility: should be over 32%
• Morphology should be over 4%; it can be displayed through a special coloring technique called KRUGER TEST.
• Leucocyte should be below 1 million/ml
• Round cells should be less than 5 million
• Viability (healthy sperm) should be over 58%
• Immunobead agglutination (MAR test): should be less than 50%
• Zinc > 2.4
• Fructose >13

SOME TERMS IN LINE WITH SPERMIOGRAM RESULTS;

- NORMAZOOSPERMIA: Normal sperms in terms of number, motility and shape.
- ASPERMIA: No ejaculates.
- AZOOSPERMIA: Semen exists, however doesn’t contain any sperms.
- OLIGOSPERMIA: The condition of having less than 15 million/mL sperms.
- SEVERE OLIGOSPERMIA: The condition of having less than 5 million/ml sperms.
- ASTENOSPERMIA: Sperm motility is weak.
- TERATOZOOSPERMIA: It’s used for sperms in which normal shaped sperms are below 4% according to Kruger criteria.
- POLYSPERMIA: Sperm number is over 250 million.
- HYPOSPERMIA: Sperm volume is less than usual..
- HYPERSPERMIA: Sperm volume is more than usual.
- OLIGOASTENOZOOSPERMIA: It’s used for sperm samples with number and motility values lower than usual ones.
- OLIGOTERATOZOOSPERMIa: It’s used for sperm samples with morphologic structure value lower than usual one.
- OLIGOASTENOTERATOZOOSPERMIA: It’s used for sperm samples below the usual values in terms of both motility and morphological structure.
- HEMATOSPERMIA: More blood cells are present in the seed.
- NEKROSPERMİ: More dead cells are present in the seed.

Interpretation of sperm analysis:

Typically 3 characteristics are examined during semen analysis. First one is the number showing production. The other two are motility percentage and morphology which show the quality. When there are problems in the sperms, usually these 3 parameters are effected all together. However, in some cases these parameters can reduce independent from other two.

Presence of the values above after sperm analysis doesn’t mean that the pregnancy is certain. For example, while the partners of males with 5 million/ml sperm concentration can become impregnated, partners of some males with 80 million/ml sperm concentration may not.

 

What Is Kruger Method?
There are few criteria for the evaluation of sperms. "Kruger criteria" is a microscopic evaluation method that focuses of the sperm deformities.

Fertility capacity of sperm sample is determined by examining the Characteristics of sperm shape after a special painting.



When it comes to morphology (kruger test), the ratio of normal sperms against abnormal ones is evaluated. If normal shaped sperms are less than 4%, this is called deformity. The effect of deformity on the normal pregnancy is debatable when the number and motility of sperms are normal, however, it may cause delay in the normal pregnancy by reducing the quality of sperms. 

IMPORTANT FACTS ABOUT SPERMIOGRAM;• The urine should be discharged completely before giving a sperm sample.
• Hands should be washed with soap and dried before giving a sperm sample.
• Sperm sample must be given by masturbating. No lubes (soap, saliva, oil, vaseline etc.) or condoms should be used during this process.
• The boxes for sperm sample are sterilized. You shouldn’t touch the internal parts of the lid and the box.
• All the semen coming out of the penis should be given in the box. If any of them are spilled outside the box, this should be told to the physician.
• Sperm sample should be taken to lab in maximum 30 minutes with room temperature or body temperature without exposure to sun.

© 2016 - Op. Dr. Cem ÖZLÜK