The seminogram, also known as spermiogram, is a diagnostic test that evaluates semen quality. The goal is to assess if male fertility it is a hindrance that impedes pregnancy.
In order to pronounce a diagnose of male infertility, at least two seminograms have to be carried out, leaving some months of interval between each one. The results, nonetheless, have to be the same each time, as they might be alterered by environmental or laboratory factors, not just physiological.
Evaluating the semen sample
The procedure requires the patient to abstrain from sex and/or ejaculation for 4 to 6 days. It would be advisable to collect the sample at the clinic, however, to do it at home is acceptable, provided that the clinic will receive the fresha sample in less than 30 minutues from the moment of ejaculation.
There are two types of examinations when evaluating semen quality: macroscopic and microscopic exam. Despite there are basic study parameters, each clinic or laboratory may add or subtract some of them when performing the analysis. In 2010, the World Health Organisation updated its reference values for semen analysis; they can be used as a guideline. Values that are outside the reference values are not considered normal.
Basic characteristics of semen are evaluated in this stage, the most important are:
- Volume: measured in millimetres(ml), it’s the quantity of semen released during ejaculation. An volume equal or higher than 1.5ml is normal, according to the WHO parameters.
- Liquefaction: the sample resting for 20 minutes at room temperature becomes less compact, and the microscopic exam can be conducted.
- Viscosity: analysed by the presence of fibers; in cases of extreme viscosity the fibers must break down so that the spermatozoa can move freely inside the seminal fluid.
- Color: semen has a withish or yellowish color. If it is slightly translucid, the presence of leukocytes in the ejaculate may be the reason, although it will be confirmed in the microscopic observation.
- pH:normal pH values are between 7.2 and 8.0, which are considered slightly basic levels; pH variation can indicate the presence of a infection.
- Presence of leukocytes or epithelial cells: it is frequent ot find other cell types (aside spermatozoa), like the sloughing of epithelial cells or leukocytes. Samples with high leukocyte rate may indicate the presence of an infection.
- Sperm concentration: two values are taken into account: sperm concentration per millilitre (ml), considered to be normal when it is equal or higher to 15 mill/ml, and the total amount of sperm in the ejaculate, being 39 million of spermatozoa in the ejaculate the reference value set by the WHO.
- Motility or sperm motility: the ability to move of the spermatozoa is analysed. Generally, two values are studied: total movement (counting the units that move), reaching at least 40%, and progressive motility (the sperm moves and swims). The cut-off point for the latter is 32%. Several clinics analyse how fast they move (fast, moderate, slow).
- Vitality: analysed by a staining test, performed only when there is a large number of nonmotile spermatozoa, therefore assessing whether this sperm is dead or alive (but nonmotile). At least 58% of the sperm has to show that characteristic.
- Morphology: the shape of the head is evaluated (it has to be rounded), and also the existence of a midpiece and tail. Normal morphologies,according to WHO standards, have at least 4% of the spermatozoa with proper form (head, midpiece, tail).