What Is Normozoospermia? – Meaning & Diagnosis

By (gynecologist), (embryologist), BSc, MSc (embryologist) and (invitra staff).
Last Update: 05/24/2021

Normozoospermia or normospermia is the term used by specialists to refer to a normal semen sample, that is, without any alteration that indicates a problem of sperm quality or male infertility.

The concept of normozoospermia can be found in the final result of the seminogram report, the test that evaluates semen quality.

In order for a semen sample to be considered normozoospermic, it must meet the parameters set by the World Health Organization (WHO) in 2010. When any of the semen parameters are altered, the semen sample cannot be classified as normozoospermic.

Basic Spermogram

The semenogram or spermogram is the most important test to assess male fertility. This study consists of evaluating a semen sample obtained by masturbation. Seminal parameters that can be observed with the naked eye are analyzed, as well as others that require the use of a microscope.

First of all, the laboratory staff that collects the sample performs a macroscopic examination of the semen, in which they assess the following parameters:

  • Liquefaction.
  • Volume.
  • Color.
  • Viscosity.
  • pH.

This is followed by a more thorough microscopic examination, in which all parameters related to spermatozoa or other microscopic cells are determined:

Each and every one of these parameters will provide information about seminal quality and possible infertility alterations that the male may suffer.

Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

What are the reference values?

Once the results of the spermogram have been obtained, they should be compared with reference values to see if they are within the normal range or not.

These criteria for normality were established by the WHO in 2010 after studying the seminal parameters of more than 1900 fertile men.

Specifically, to ensure that the man has normozoospermia and therefore does not have sterility due to a sperm factor, the semen parameters must be equal to or greater than the following values:

Semen volume
1.5 ml.
Sperm concentration.
15 million per ml or 39 million in total per ejaculate.
Sperm motility.
40% motile spermatozoa or 32% progressively motile spermatozoa.
Sperm Morphology.
4% normal sperm.
Sperm Vitality
58% normal sperm.

These indicated values correspond to the lower reference limits (LRI) of the semen parameters. This means that, in order for a male to be considered fertile or normozoospermic, his seminal parameters must be higher.

Other parameters

Although the sperm parameters mentioned in the previous section are the most important for assessing semen quality, there are also other parameters related to semen and its components that can provide relevant information.

For example, the color of semen must be yellowish-gray to be considered normal. Very clear semen is associated with seminal infection. In addition, its viscosity should not be too high.

As for the pH of the semen, it should be kept in the 7-8 range. Variation in pH may also indicate infection.

On the other hand, the concentration of leukocytes or round cells in the semen should not be higher than 1 million per ml to rule out problems in spermatogenesis or infections.

Normozoospermia and pregnancy

As has been mentioned throughout the article, those men who present a semen analysis with a result of normozoospermia, do not have any sperm alteration. Therefore, pregnancy in a natural way would be possible.

However, if you have been having sex for more than a year without success, it is best to consult a fertility specialist. It is possible that there is some alteration in the DNA of the spermatozoa and this cannot be detected by a semen analysis. The main consequence of alterations in sperm DNA is usually fertilization failure, but it can also cause embryo implantation failure in the uterus. Therefore, the pregnancy would not go to term.

FAQs from users

Despite normozoospermia we aren't able to get pregnant. Which other tests could we get done?

By Dr. José Luis Gómez Palomares (gynecologist).

As stated in the Manual of Andrology of the Spanish Society of Fertility: "although the results of semen analysis can give us information about problems in the function of the male genital organs, they do not allow us to determine with certainty whether an individual is fertile or not". So, if the semen analysis is normal, should other tests be performed? In the initial assessment of a couple with reproductive dysfunction, no. The seminogram is more a tool to guide treatment than to reach a diagnosis.

It is true that there are other complementary tests that can help to study the semen in greater depth, such as the study of the double-stranded DNA fragmentation of the spermatozoa. This type of test promises to advance in the evaluation of the male but even so, we insist, they are not indicated in the initial study of a couple with reproductive dysfunction. Even if you have normozoospermia.
Read more

Can I have a male fertility problem if I have been diagnosed with normozoospermia?

By Sergio Rogel Cayetano MD (gynecologist).

The diagnosis of normozoospermia refers to semen that meets the parameters defined by the WHO in the seminogram. It is an observer-dependent, variable test (as men do not always have the same number of spermatozoa or motility at all times in their lives) and is really old and not very technological.

To date, we have few tools for a more in-depth assessment of the male factor. However, in recent years, male factor research has made great advances, such as sperm DNA fragmentation, sperm apoptosis, altered sperm DNA protonation and FISH in spermatozoa.

There are also many known cases of couples with sperm-attributable failures in which the sperm values of all tests performed were normal, but in which success was only achieved after sperm donation therapy (these are rare cases in which all known tests and therapies have been tried beforehand).

The alterations in all the parameters and tests mentioned above could explain male fertility problems that could occur with a normal sperm count.
Read more

Can oligozoospermia go away on its own and result in normozoospermia?

By Zaira Salvador BSc, MSc (embryologist).

Yes. Sperm quality varies quite often and is dependent on lifestyle factors. It is likely that stress or the flu affect spermatogenesis, and the results of a semen analysis report appear altered, including problems of oligozoospermia, asthenozoospermia, etc.

The good news is that a man can recover his fertility within 3 months if the cause of infertility is improved or disappears. A balanced diet, doing sports, and quitting toxic habits can contribute to improving sperm quality to a large extent.

Is normozoospermia possible with increased viscosity levels?

By Zaira Salvador BSc, MSc (embryologist).

Viscosity is more related to the composition of the semen than with spermatozoa themselves. Even though high viscosity levels rarely cause male infertility, it might be associated with sperm motility issues. For this reason, it should be taken into account when performing a semen analysis.

Moreover, too high viscosity levels are associated with prostate complications

Can I get my wife pregnant with normozoospermia?

By Zaira Salvador BSc, MSc (embryologist).

In principle, yes. As explained above, normozoospermia means normal sperm, which is considered the ideal scenario to conceive according to the WHO's guidelines.

A man with good sperm quality is someone whose sperm are able to travel through the female reproductive tract and reach the egg.

In spite of that, it is possible for sperm to carry DNA abnormalities that cannot be detected through a basic semen analysis. In that case, in spite of being normozoospermic, fertilization or implantation failure could take place.

Can I have normozoospermia if I have hypospermia?

By Marta Barranquero Gómez (embryologist).

No. Normozoospermia is the term used to refer to semen samples that have all parameters within the normal range.

However, hypospermia is a sperm disorder characterised by a low ejaculate volume. If the rest of the sperm parameters are within normal, the diagnosis would only be hypospermia.

Suggested for you

If you have just had a semen analysis and you are not very clear about the values you have obtained, we recommend that you continue reading here: Sperm Test Results Explained - Interpretation & Normal Values.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Bartoov B, Eltes F, Pansky M, Lederman H, Caspi E, Soffer Y. Estimating fertility potential via semen analysis data. Hum Reprod 1993;8:65 – 70.

Check JH, Bollendorf A, Press M, Blue T. Standard sperm morphology as a predictor of male fertility potential. Arch Androl 1992;28:39 – 41.

Chia SE, Tay SK, Lim ST. What constitutes a normal seminal analysis? Semen parameters of 243 fertile men. Hum Reprod 1998;13:3394–3398.

Coetzee K, Kruger TF, Lombard CJ. Predictive value of normal sperm morphology: a structured literature review. Hum Reprod Update 1998; 4:73 – 82.

Guzick DS, Overstreet JW, Factor-Litvak P, Brazil CK, Nakajima S, Coutifaris C, Carson SA, Cisneros P, Steinkampf MP, Hill JA et al. Sperm morphology, motility, and concentration in fertile and infertile men. N Engl J Med 2001;345:1388 – 1393.

MacLeod J, Wang Y. Male fertility potential in terms of semen quality: a review of the past, a study of the present. Fertil Steril 1979;31: 103 – 116.

Macomber D, Sanders MD. The spermatozoa count: its value in the diagnosis, prognosis and concentration in fertile and infertile men. N Engl J Med 1929;200:981 – 984.

Trevor G. Cooper, et al. World Health Organization reference values for human semen characteristics. Human Reproduction Update, Vol.16, No.3 pp. 231–245, 2010.

FAQs from users: 'Despite normozoospermia we aren't able to get pregnant. Which other tests could we get done?', 'Can I have a male fertility problem if I have been diagnosed with normozoospermia?', 'Can oligozoospermia go away on its own and result in normozoospermia?', 'Is normozoospermia possible with increased viscosity levels?', 'Can I get my wife pregnant with normozoospermia?' and 'Can I have normozoospermia if I have hypospermia?'.

Read more

Authors and contributors

Dr. José Luis Gómez Palomares
Dr. José Luis Gómez Palomares
Gynecologist
Degree in Medicine from the University of Valencia, specialized in Obstetrics and Gynecology at the Son Dureta Hospital in Palma de Mallorca. He has an extensive career as a gynecologist specializing in assisted reproduction and is also a scientific disseminator through the Youtube channel Feliztividad: hábitos de éxito y diferentes podcast. More information about Dr. José Luis Gómez Palomares
Licence number: 280705568
 Marta Barranquero Gómez
Marta Barranquero Gómez
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Romina Packan
Romina Packan
inviTRA Staff
Editor and translator for the English and German edition of inviTRA. More information about Romina Packan

Find the latest news on assisted reproduction in our channels.