Spermogram analysis is a rather complex study, the accuracy of which depends on a number of factors: the doctor's skill, the work of laboratory equipment, and .Also, for maximum reliability of the result, it is necessary to properly prepare for the study.
This study is relatively effective and has a large list of indications. It is the decisive method in determining the function performed by the sex glands and the state of fertility and health of a man, his spermatogenesis. Also, with the help of this analysis, we can conclude about the overall functioning of all glands that contribute to the formation of male ejaculate. In addition, the study, as a rule, includes an analysis of the content of antisperm antibodies.
In determining the fertility and fertility of a male, is measured by the sperm volume of , counting the number of spermatozoa and their microscopic examination. The technique of counting the number of sperms is similar to the method of counting the number of blood cells. Determination of the motility of spermatozoa and their shape is carried out by examining a colored semen drop with a microscope. In case of any deviations from the norm, to determine their causes and to exclude various biochemical pathologies, additional tests are used( analysis of the function of the thyroid gland, liver, adrenal glands, etc.).With a marked decrease in the number of spermatozoa, their mobility, or the appearance of a large number of abnormal cells, the performance of a testicular biopsy is indicated.
- 1 Purpose of the study
- 2 Purpose of the study
- 2 Preparing for the
- 3 study Equipment and carrying out
- 4 Normal sperm
- 5 Deviations from the normal parameters
- 6 Factors affecting the reliability of the result
Purpose of the study
So, human sperm is being investigated for the following purposes:
- Conducting the spouse's fertility assessment if availableinfertility ;
- To confirm the effectiveness of the procedure for male sterilization;
- To exclude probable paternity when a man is sterile.
Preparing for the
study In order to obtain a reliable result, you must correctly prepare for the analysis:
- Physicians are required to instruct a man( in two forms: in writing and orally) that sperm should be obtained by masturbation, preferably within the walls of a medical institution or laboratory( the most optimal option).Since its supercooling or overheating( even short-lived) will lead to a distortion of the result;
- To obtain a reliable result it is necessary to collect completely the entire volume of isolated semen;
- The patient needs to withstand the period of abstinence from sexual intercourse equal to 3-4 days before the test, which is important for the presence of more spermatozoa in the sample;
- For the same amount of time, it is necessary to exclude the use of alcoholic beverages, medications( except those that are vital, which must be reported to the doctor), you can not take a hot bath and bathe in a bath;
- If the patient wishes to obtain a sperm sample at home, he should be informed that it must be delivered to the laboratory within one hour. In this case, it is necessary to protect the material from overheating, and in winter - to prevent its freezing. The most optimal is the storage of the sample at room temperature for 20 minutes before the onset of its dilution;
- Alternative ways of collecting ejaculate are interruption of sexual intercourse or condom. With PPA, sperm must be collected in a container just before it is ejected. When using a condom( which is not very desirable, since the lubricant that covers it reduces the mobility of the cells), it must be thoroughly washed with soap, washed and dried. Then, after the act, it should be tied up, put in a container and brought to the study;
- There is also a method for collecting sperm from the vagina of a woman after the act, which allows an evaluation of the ability of male cells to penetrate through the mucus of the cervix, while maintaining activity( postcoital Sims-Juner test).This study is carried out one to two days before the onset of ovulation, which is determined by the basal temperature curve. If the cycle of a woman is irregular, then its middle is found by evaluating the level of the hormone in the urine. It is necessary to abstain from the sexual life of both partners for a minimum of two days, sexual intercourse should be optimized no later than 8 hours before the time of the study. Do not use any lubricants;
- Sperm research should be performed at least three times with a break of two weeks to obtain the most reliable result. Also at this time, a MAR test is done to exclude the immune form of infertility.
Equipment and Conducting
To determine fertility, the patient collects semen by masturbation or PAP in a clean plastic container( disposable urine collection container). In this case, the patient should remember that the loss of sperm in the collection process during ejaculation is undesirable .
A woman's sperm is collected in the doctor's office after a sexual act, by vaginal examination with mirrors and aspirating the contents from the cervical canal with a tuberculin syringe without a needle. If there is no emission of sperm, then it is obtained surgically. Also, in the absence of sperm and an existing orgasm, it is possible to perform a sediment study in a urine sample taken immediately after intercourse to detect the presence of spermatozoa in it. A positive result indicates that there is retrograde ejaculation. The result of the study is usually ready in 24 hours.
In a healthy male, sperm normally has the following indices:
- Time required for liquefaction. This feature is one of the first to be studied, since initially the consistency of the sample is viscous and transparent, then the semen is diluted for 20 minutes under the influence of the enzymes that it contains. In the event of an increase in the timing of this process, a violation of the function of the prostate gland is suspected. After liquefaction of sperm at normal viscosity, it flows out of the laboratory capillary with droplets;
- The color is normally whitish-gray or yellowish, depending on the nutrition of the male. The presence of a pink shade indicates an excessive amount of red blood cells;
- The volume of the portion, which under normal conditions is at least two milliliters and is a very important indicator. With a small amount you can suspect oligospermia, which is often the cause of infertility. However, an increased volume of sperm is also not a favorable sign, in most couples who are being treated for infertility, the amount of ejaculate is increased. Also, the sexual abstinence of a man for more than one week leads to an increase in the volume of the sample. If a man abstains until ten days, this helps to increase the amount of sperm and reduce the mobility of spermatozoa;
- The acidity of the medium, which is normally slightly alkaline, is between pH 7.2 and 7.8.Minor deviations are permissible, but without other violations. The combination of a complex of changes allows you to suspect some kind of pathology;
- The study of the number of spermatozoa is an extremely important indicator, the evaluation is carried out in millions of cells per 1 milliliter of .Normally, the amount varies from 20 to 140 million in 1 ml( or 40 million for the whole portion of the ejaculate).At the same time, at least 40% of spermatozoa should have a normal structure;
- Cell mobility study. Normally, more than 20% of spermatozoa gradually increase in mobility within four hours after sampling. Evaluation of this indicator is carried out according to several criteria: category A - spermatozoa move quickly and rectilinearly, category B - move slowly and straight, C - the character of the movement is non-rectilinear and intermittent( floundering or motion in a circle), D - there is no mobility of the cells. In the sample there are, as a rule, all the aforementioned groups of spermatozoa. Normally the ratio is as follows: the sum of A + B is about 50%, or the number of cells in category A is at least 25%.This group consists of young and healthy cells. Also in the sample there are always dead spermatozoa from group D, their quantity is about 40% of the volume of the portion. And category C is still alive, while close to death cells, their number is on average 10%.
Deviations from normal indices
An increase in the number of dead cells from category D or from group C indicates the appearance of antibodies to sperm cells. The observed changes in the norm are not yet a sign that the man is infertile, since in order to fertilize the egg, one healthy male cell is sufficient. And although the normal content of spermatozoa is not less than 20 million in 1 ml, those men with a cell concentration in the sperm of not more than 1 million / ml are capable of fertilization. Absolutely sterile are men, whose sperm have no living cells at all. However, a decrease in the number of spermatozoa in the sperm volume, their altered morphology and impaired mobility( may be with epididymitis) indicate a decrease in fertility. In these cases, additional examinations and assessment of metabolism and the state of endocrine organs are necessary.
Factors influencing the reliability of the result
The uncertainty in the results can be in the following cases:
- When the test is performed on the wrong day of the woman's menstrual cycle( when taking a sample from the vagina);
- If a woman has previously undergone cervical treatment;
- When taking medicines by a man;
- In case of incorrect delivery of a sample of sperm to the laboratory( overheating, exposure to sunlight, delivery in a condom), which can reduce the number of live cells ;
- Because of the small amount of sperm, not completely collected sample( violation of collection technique);
- Sperm motility may also be affected by excessive amounts in the leukocyte sample in the presence of inflammatory processes in the genito-urinary tract.