MALE

Semen analysis (spermiogram)

The most simple and informative test to assess semen quality is a spermiogram or seminogram. However it is important to remember that even though sperm are ejaculated they may not be fertile.

How should you collect a sample?
What is analysed in the spermiogram?
  • The sample is collected by masturbating into a sterile jar, similar to those used for a urine sample. We provide the jar at TAHE FERTILITY, or they are available in pharmacies.
  • You should NEVER use a condom to collect semen as they contain spermicides and will give an incorrect result.
  • It is important that the semen is as fresh as possible when received by the clinic. It should not be more than an hour old.
  • When handing in the sample to TAHE FERTILITY staff it is important to indicate:
    • The time the sample was collected.
    • If any of the sample has been lost.
    • Any illness or fever in the last 3 months.
    • Any medication you are taking.
    • The time since the previous ejaculation, as the spermiogram must be carried out 3 to 5 days afterwards.
  • The volume of semen: The World Health Organisation (WHO) has determined that between 2 and 6 ml is normal. If the sample is less than 2ml it is possible that the sample has been collected incorrectly. This may also indicate a problem in the seminal vesicles or even an obstruction in the ejaculatory duct. A high volume of semen may indicate a seminal vesicle hypertrophy or prolonged sexual abstinence.
  • pH: Alterations in the semen pH level are indicative of problems with the prostate or the seminal vesicles.
  • Viscosity: If the semen consistency is thicker than normal it could impede the movement and progression of the sperm.
  • Liquefaction: A normal semen sample will become liquid at room temperature approximately 15 to 30 minutes after ejaculation, but sometimes it can take longer than 60 minutes. This should be recorded and may indicate an insufficient level of a prostate enzyme.
  • Colour: Human semen is normally a homogenous opalescent liquid white or yellowish in colour. A different colour may indicate an inflammation of the seminal ducts, infection, etc. For example, a pinkish colour shows the presence of blood in the semen.
  • Agglutination: Semen is considered to be agglutinated when groups of mobile sperm can be seen in a clump, which means they cannot progress. This can suggest the possibility of anti-sperm antibodies in the semen.
  • Leucocytes: The presence of a high number of leucocytes in the semen can indicate an infection in the seminal ducts, which would need to be diagnosed and treated.
  • Sperm count: The quantity of sperm present in the ejaculated semen is important, as a low number can result in infertility. The WHO has determined that more than 20 million sperm per millilitre is normal. However, it is still possible to achieve fertilisation with a lower count.
  • Sperm motility: The percentage of mobile sperm is also an important factor of fertility. A sufficient number of mobile sperm must be left in the vagina after intercourse to find the egg in the fallopian tubes.
    The WHO determines 3 categories of motility:

    • Progressive motility (PR): spermatozoa moving actively, either linearly or in a large circle, regardless of speed.
    • Non-progressive motility: all other patterns of motility with an absence of progression.
    • Immotility (IM): no movement.

Diagnostic preparation

Consists of making a seminal preparation, in the same process as artificial insemination, but with the objective of diagnosing whether the semen sample is of sufficient quality to be valid for artificial insemination or whether the couple should opt for in vitro fertilisation (IVF). This test is carried out for males who have medium seminal quality to determine the most appropriate treatment for the couple.

Quality of sperm DNA

In the TAHE FERTILITY andrology laboratory we can determine the presence of breakages in the sperm’s DNA chains. Breakages can be due to certain pathologies in the male and may be the cause of failure in embryonic implantation or even of miscarriage. A diagnosis of a high number of breakages in the DNA can result in several treatment options for the couple.

Evaluation of the number of chromosomes in the sperm

Using the FISH (Fluorescence in situ Hybridisation) technique, we can analyse the chromosomes in the sperm. Human cells have 46 chromosomes, but sperm and eggs have 23 each. When a sperm has 22 or 24, the resulting embryo will also have one more or less, which can lead to miscarriage or failure to implant. This test is therefore recommended if a couple report these problems, or if the male has a very low sperm count.

If a patient has a higher percentage of sperm with alterations to the chromosome count, it is necessary to study the resulting embryos to identify the normal chromosomes. This is done by carrying out a cycle of in vitro fertilisation with pre-implantation genetic diagnosis (PGD).