We usually talk about female infertility and the tests to diagnose it. But it is estimated that in 30% of infertility cases the origin is in man. For this reason, in this blog we are going to tell you what the seminogram is, how it is performed and what is the usefulness of this test.
Are seminogram and spermiogram the same?
Yes, they are the same. These are two words that can be used interchangeably to describe this test. It is one of the most important diagnostic-oriented tests in men. It consists of analyzing the quality of sperm, macro and microscopically. Thanks to this laboratory test, the cause that explains the inability to conceive naturally can be diagnosed. As mentioned, it is a test that is performed in the andrology laboratory. It takes 3 to 5 days of sexual abstinence to collect the semen sample to be analyzed. The seminogram is performed once 30 minutes have elapsed since the ejaculate.
What parameters are studied in the seminogram?
- ejaculate volume
- Number of gametes per milliliter
- Mobility level of male gametes
- Morphology of said spermatozoa
And, in case you have any more doubts, Olga Ruiz, director of the IVF and Andrology laboratories at IVI Málaga, tells you about it in this video:
When is a seminogram considered normal?
The World Health Organization (WHO) has established a series of indicators to evaluate the result of a seminogram as normal. According to these parameters, this analysis is considered normal when:
- An ejaculate volume equal to or greater than 1.5 ml is given
- At least a concentration of 15 million/ml
- A total of 39 million sperm in the ejaculate analyzed
- A minimum of 40% of gametes in movement and another 32% with progressive mobility
- Around 58% of the sperm must be alive
- A minimum of 4% with normal morphology
What happens if the seminogram shows a low sperm count?
If the seminogram shows that there is less sperm in the ejaculate than that established by the WHO (<15 million/ml or <39 million per ejaculate) it results in an insufficient number. If this occurs, it is what we know as oligospermia. This can be mild, moderate or severe. This last case occurs when there are less than 1 million male gametes per ml. It must be taken into account that the lower the concentration of gametes in the sperm, the greater the difficulties in achieving pregnancy.
What if the seminogram shows a total absence of sperm?
The complete absence of sperm is known as azoospermia. This diagnosis shows the inability to achieve pregnancy naturally. Azoospermia can reside in the inability to produce sperm and/or in the obstruction of the ducts that transport them
How to interpret a reduced number of motile spermatozoa?
As we said at the beginning, the WHO sets as one of the normal parameters in a seminogram that at least 40% of the spermatozoa are motile. Values below this figure indicate that we are facing asthenozoospermia. The lower the percentage of motile sperm, the more difficult it is to achieve a pregnancy naturally
Low morphologically normal sperm count
It is required that at least 4% of the spermatozoa in a sample have a normal morphology; values below this figure indicate a situation of teratozoospermia. For a spermatozoon to be considered morphologically normal, it must present: an oval head, a straight flagellum and a fixed nucleus; transparent and with regular contours. But if the spermatozoon presents morphological abnormalities in the head (elongated, very large,) middle part or flagellum (double, coiled in a spiral) it is considered morphologically abnormal. Teratozoospermia can occur in different degrees and have various consequences ranging from slowing the movement until it stops progress completely or eliminates its fertilization potential
vitality test
We speak of necrospermia when less than 54% of the spermatozoa analyzed in the seminogram are alive. The fact that a spermatozoon is immobile does not imply that it is inviable or that it is dead, since it can keep its structures intact and yet not have mobility. Therefore, in those samples in which the percentage of spermatozoa with progressive mobility is below 40%, the WHO recommends additionally carrying out a sperm vitality study, which determines the proportion of live spermatozoa in the ejaculate. Necrospermia can be a consequence of genital tract infections, trauma, medical treatment, etc.
As in other cases, necrospermia can occur totally -absence of living spermatozoa- or partially. This diagnosis can be caused by infections of the genital tract, by trauma, medical treatment or genetic anomaly, among others.
What happens if the seminogram shows a low ejaculate volume?
In cases where the volume of the sample analyzed is less than 1.5 ml, we speak of hypospermia. It can originate in patients with total or partial obstruction of the seminal tract, androgen deficiency, incomplete ejaculation or loss of part of the sample.
What to do if the seminogram result is abnormal?
If the results of the seminogram show one or several alterations in the quality of the semen, it will be the specialist himself who will indicate the need to repeat the analysis. Normally these are recommended to be done in periods of three months, since it is at this time when spermatogenesis occurs. If the diagnosis is confirmed in repeated seminograms, additional tests could be recommended to allow the scope of infertility to be measured. These tests could be at the hormonal level, a scrotal ultrasound or a karyotype.
Solutions for low semen quality
Given this diagnosis, assisted reproduction can help achieve the desire to be parents.
Spermatozoa with a minimum of motility and with a sufficient concentration: In Vitro Fertilization (IVF) can be performed with the couple’s oocytes.
Low sperm count or poor mobility: ICSI (intracytoplasmic sperm injection) is recommended, which is a variant of conventional IVF. In this technique, the selected spermatozoon is introduced into the oocyte, to maximize the chances of fertilization.
Low quality sperm: you can resort to IVF with sperm donation.
If you need more information about the seminogram and fertility diagnosis, you can contact our team at 900847300 or on the contact form to make an appointment at IVI. We are leaders in reproductive medicine worldwide and we can help you fulfill your dream of being a mother.
