Half of the cases of infertile marriage are due to male infertility. Only a thorough examination can reveal the cause of infertility. The doctor, if indicated, prescribes a spermogram with several additional studies that will help to specify the diagnosis.

Preparation for the spermogram

Before undergoing a spermogram, a man needs to refrain from ejaculating for several days. If the period is reduced to one day, the amount of sperm will not be enough; if the period of abstinence is increased for more than seven days, the motility of spermatozoa decreases significantly. Before the examination, you should not visit a sauna or steam room, or drink alcohol. The result of a spermogram can vary for reasons independent of the man, so it happens that the indicators are accurate, the doctor prescribes an additional examination with sperm donation.

The sperm obtained by masturbation is placed in a sterile container. The VITROMED clinic has a comfortable special room for this procedure.

By examining sperm under a microscope, experts determine the following parameters::

The number of spermatozoa per milliliter of ejaculate. High-quality sperm should contain at least 15 million per milliliter according to the latest criteria of the World Health Organization (WHO) from 2010. If there are fewer spermatozoa, oligozoospermia is diagnosed, and if there are no spermatozoa, azoospermia is diagnosed.

The motility of spermatozoa. Sperm is considered normal if 32% or more of the sperm are able to move in a straight line. This is exactly the movement they make in the cervical canal, moving towards the uterus and into the fallopian tubes. Good motor activity helps spermatozoa pass through cumulus cells and penetrate through the pellucid zone. With sperm motility rates of less than 32%, asthenozoospermia is diagnosed. In this case, the chances of conception decrease somewhat. They become even fewer if the number of spermatozoa in the ejaculate is less than normal.

Morphology of spermatozoa. Their structure and shape are considered here. Healthy, high-quality sperm cells should have an oval head and a slightly curved tail.

Every man has spermatozoa with abnormal development. The opinion that they can lead to conception of a child with birth defects is incorrect. Experts say that spermatozoa that have a pathology in their structure are unable to fertilize an egg. They are dangerous in another way. If their number is large enough, then this can affect the chance of normal sperm cells to penetrate to the egg and fertilize. A reduced number of normal spermatozoa is called teratozoospermia.

Decoding the spermogram

Kruger morphology is a complex laboratory process that is performed only in specialized clinics offering infertility treatment to patients. In Armenia, such a study is offered only by the «VITROMED» Clinic.

According to the Kruger criteria, normal sperm contains from 4% of spermatozoa with normal morphology. For the first method of assessing sperm quality, this figure is 50%. When studying the morphology of spermatozoa, a doctor should also pay attention to the increased number of white blood cells. Since their large number often indicates that the patient has an infection of the genitourinary system.

When the examination results show that there are few spermatozoa in the sperm and they have low viability, the patient is asked to undergo a second analysis procedure.

Antisperm antibodies (MAR-test)

In order to know how to improve sperm quality, it is necessary to take a test to detect antisperm antibodies that affect sperm clumping, reduce motility and the ability to fertilize an egg. Such antibodies can be found equally in the body of both men and women. Antisperm antibodies are formed when the immune system, perceiving the sperm as a foreign body, begins to destroy them. An analysis for antisperm antibodies is taken from both spouses. Blood, semen, and cervical mucus are examined.

The function of spermatozoa will be significantly impaired if a large number of white blood cells are found in the sperm. The round shape of white blood cells usually makes it quite easy to identify them. But, in the case of a spermogram, this is not the case. Immature sperm cells look very similar to white blood cells. To identify their differences, it is necessary to use special dyes, namely, the leukoscreen test is performed.

The detection of a large number of immature sperm cells in the ejaculate may be the cause of infertility. Leukocytes in semen can diagnose the presence of infectious manifestations in the genitourinary system. Back-sowing of sperm will be necessary if the sperm contains more than 1 million/ml of white blood cells.

3. Transrectal ultrasound examination

This research method is indicated for the detection of pathological formations and changes in the structure of the prostate gland, testicles and appendages. Transrectal ultrasound is indicated for azoospermia. It reveals changes in the seminal vesicles in case of obstruction of the vas deferens.

Scrotal dopplerography can detect venous reflux in the testicular blood supply system and subclinical varicocele.

The vas deferens are examined by vasography. It allows you to obtain a high-quality image of the vas deferens and vas deferens and determine the places of their obstruction.

4. Vasography

5. Genetic research

If large morphological changes are found in the structure and shape of spermatozoa, or the patient is diagnosed with azoospermia, a genetic study is prescribed.

Karyotyping (genetic analysis) detects changes in the structure and number of chromosomes in the patient. The study of the AZF locus of the Y chromosome is also often used. In non-obstructive azoospermia, several parts of this chromosome locus may fall out.

Genetic research provides a lot of information about the transmission of non-obstructive azoospermia by inheritance. The doctor always tells the patient about this fact of a hereditary disease.