Sperm analysis: checking fertility in men

When is a spermiogram done?

In about 40% of the cases in which couples remain unintentionally childless, the source of the problem lies with the man . In order to determine the causes of temporary or permanent infertility in men, a detailed sperm analysis is often carried out. Your results provide information about various factors that can influence fertility and are evaluated and displayed in a so-called spermiogram. The spermiogram provides an overview of the properties of the sperm and helps to assess the chances of success of natural or various forms of artificial insemination .

Sperm analysis: procedure of the sperm test

1st step: sperm sample

The sperm sample, which is the basis of the analysis and the spermiogram, is obtained from the patient through masturbation. Most urological or andrological practices have a room specially designed for this purpose. If it is not possible to take the sample undisturbed in a practice, this can also be done at home. However, the sample must then be brought to the laboratory for ejaculate analysis within a maximum of two hours. When transporting, care should be taken to transport the dispensing cup and its contents at body temperature, for example in your trouser pocket, so that the values ​​relevant for the examination are not falsified.

Before collecting the sample, the patient should be abstinent for about three to five days to ensure the best possible sperm quality in the ejaculation. With each ejaculation, the number of sperm already formed in the epididymis decreases and it takes a few days to replenish the “stores”. Therefore, the short waiting period for the spermiogram is recommended in order to form as many healthy sperm as possible. A waiting period beyond the five days does not further improve the results. Waiting too long even causes the sperm to lose mobility.

2nd step to the spermiogram: liquefaction of the sperm

Once the sperm sample has been received by the andrology laboratory, the examination of the semen begins. For this purpose, the properties of the ejaculate are considered individually and then evaluated according to the standards set by the World Health Organization (WHO). As a first step, the liquefaction time of the sperm is determined. After about 15 to 30 minutes, its consistency should have changed from gelatinous to liquid.

If this liquefaction does not occur even after an hour, one can speak of a hyperviscosity disorder. This means that the sperm cannot move quickly enough to the target due to the lack of liquefaction in the woman’s body. In such a case, the sperm can be processed with certain enzymes and artificial insemination can be carried out.

3rd step: assessment of the sperm

As the next step in creating the spermiogram and assessing the sperm, the ejaculate is evaluated according to additional, obvious criteria. Appearance, smell and color, for example, are included in the assessment. The amount of semen should not be less than 2ml. This value alone does not allow any conclusions to be drawn about a man’s fertility, because the semen consists of only about 3 to 5 percent sperm. The rest of the fluid is made up of secretions from the prostate, epididymis and seminal vesicles. The latter forms the majority of the semen with 60 to 70 percent.

In addition to protein, this secretion mainly contains fructose, which supplies the seminal fibers with energy for movement. If too little semen is released during ejaculation, this can indicate a disorder of the seminal vesicles and have negative effects on sperm motility and thus reduced fertility.

Sperm analysis

After the above examinations have been carried out, the sperm are analyzed under a microscope. To do this, the liquefied sperm is mixed and then a defined amount is counted under the microscope in a specific counting chamber. The sperm concentration in the entire ejaculate can be calculated from the values ​​obtained. Here you will find an overview of normal values ​​of a spermiogram , which come from the 2010 edition of the “ WHO laboratory manual for the examination and processing of human semen ” published by the WHO. In addition, the shape of the sperm and their vitality and mobility are checked. We have compiled everything related to the topic of infertility and sperm quality for you here.

What is shown in the spermiogram?

Finally, all spermiogram values ​​of the examinations carried out are summarized and clearly listed. The spermiogram serves as an overview of the patient’s condition for the attending physician and he can thus assess his fertility.

• The spermiogram values ​​provide indications of reduced sperm quality (the so-called OAT syndrome), for example due to too few, immobile or malformed sperm, and can therefore be diagnosed and treated accordingly.
• An infection of the seminal ducts can also be seen in the semen analysis. If there are too many white blood cells, the so-called leukocytes, in the ejaculate, this indicates an inflammation. This can then be treated with antibiotics.
• The semen analysis can also show whether there are antibodies against the semen in the ejaculate. These antibodies attack and destroy the sperm. The consequence is the infertility of the patient. In such a case, a testicular biopsy can be performed and the semen taken directly from the testicular tissue to be used for artificial insemination.

Cost of a spermiogram

Does a sperm test cost anything? Yes, as a rule, the cost of a spermiogram is around 60 to 90 euros . However, if you credibly convey to your health insurance company that you have had an unfulfilled desire to have children for a long time, it may be that the health insurance company will cover the costs of the sperm test. In most cases, health insurance companies take over such a sperm test.

Sperm analysis is just a snapshot

In general, it can be said that a spermiogram always only provides an overview of the current condition of the patient and does not represent absolute values. Therefore, the sperm test should be repeated after about four weeks before a specific therapy is initiated. This in turn depends on the severity of the fertility impairment. In most cases, which are not acute and can therefore be treated with medication or hormone preparations, artificial insemination through insemination, IVF or ICSI is necessary.

There is currently no alternative to this type of semen examination, as existing rapid tests only ever check certain parameters. However, they do not provide a comprehensive overview of the properties of the sperm.

By the way , you can read in this article how you can support fertility through a balanced diet.