The quality of sperm is determined by its special study – the analysis of sperm ( spermograms ), which consists in the study of all the ejaculate obtained to determine the quantitative, qualitative and morphological characteristics of sperm.
As a rule, spermogram is prescribed in conjunction with other tests to identify the causes of infertility in marriage, as well as for male infertility and the presence of inflammatory or hormonal diseases of the organs of the male genital sphere.
In addition, the spermogram is necessarily carried out before IVF and artificial insemination.
In order for sperm indicators to be reliable, it is necessary to prepare for its delivery:
- abstinence from 2 to 7 days (optimally 3-5 days);
- avoiding the use of alcohol, strong tea, coffee and medicines during the entire period of abstinence;
- refusal from visiting baths, saunas, taking hot baths and showers, banning solarium and sunbaths for the time period indicated above.
Sperm is given directly in the laboratory (special room) by masturbation. It is possible to bring the ejaculate out of the house, received during the interrupted sexual intercourse in a medical condom, but the delivery time should be no more than three hours, and the temperature of the delivered sperm should be about 36 ° C (underarm). It should be borne in mind that the ejaculate obtained outside the laboratory may spill on the way to it, which will affect sperm performance.
The rate of ejaculate is 3-5 ml. Reduced (less than 2 ml) indicates either a violation of the delivery of sperm to the laboratory, or the insufficiency of the functions of the sex glands (prostate, seminal vesicles and others). An increase in the number of sperm indicates the presence of an inflammatory process in the genitals.
Normally, the ejaculate color is whitish, grayish or tinged with yellow. The red or brown color of sperm indicates either a genital trauma, or a stone in the prostate or chronic vesiculitis (the red tint is due to the admixture of red blood cells).
The normal pH of semen is 7.2-7.8 (alkaline). Deviations in one direction or another indicate the inflammatory process of the sex glands.
Sperm liquefaction time should not exceed 60 minutes. In the case of lengthening the time of liquefaction sperm in the acidic environment of the vagina waste their energy and lose activity, which significantly reduces their ability to fertilize the egg. Most often, a long time of dilution is observed in chronic prostatitis and / or vesiculitis.
To determine the viscosity of the ejaculate, measure the length of the thread flowing from the end of the pipette. Normally, it is not more than 0.5 cm.
An elongated filament (increased viscosity) indicates chronic either prostatitis or vesiculitis. Thick and viscous sperm significantly reduces the chances of conception, so the sperm is difficult to move into the vagina, which further enhances the negative impact on them in an acidic environment.
The number of sperm in 1 ml of ejaculate
Normally, 1 ml of sperm should contain more than 20 million. sperm.
A decrease in sperm density is called oligozoospermia, which indicates ineffective work of the testicles (decrease of androgens, inflammation of the testicles, toxic lesion of the spermatogenic epithelium of the testicles in history, weakened immunity, metabolic disorders, etc.).
Reduced concentration reduces the chances of fertilization. An increase in sperm density or polyzoospermia (more than 120 ppm in 1 ml) precedes oligozoospermia.
Total sperm count
The total number of spermatozoa in the test ejaculate should be more than 60 million. The decrease in density is due to the same factors as the decrease in sperm concentration in 1 ml of sperm.
Chances of fertilization depend on sperm motility. There are 4 groups of sperm:
- group A – active motile spermatozoa with rectilinear motion;
- group B – sedentary sperm with rectilinear motion;
- group C – sedentary spermatozoa whose movements are oscillatory or rotational;
- group D – sperm are immobile.
Normally, there should be more than 25% of spermatozoa from group A or 50% of spermatozoa from group A and B.
Reduced sperm motility is called asthenozoosperiya and indicates inflammatory processes of the genital organs, toxic lesions and heat effects on the male sex glands (testicles).
With this indicator is determined by the number of normal sperm.
Normally, unchanged sperm should be more than 20%. About teratozoospermia say when the number of normal sperm less than 20%.
Toxicity and radiation damage, inflammatory and infectious processes, as well as ecology affect the morphology of sperm cells.
This indicator measures the percentage of live sperm in the ejaculate. The smaller it is, the lower the probability of conception. Normal live sperm should be more than 50%.
Necrospermia is talked about with a decrease in the described indicator, which can be a temporary phenomenon during intoxication, an infectious disease, and stress. Permanent nercospermia occurs when testicular lesions are affected by radiation, toxic substances, or heat exposure.
The number of desquamated cells of the spermatogenic epithelium of the seminiferous tubules should be no more than 2%.
Agglutination and aggregation
Normally, gluing of sperm (agglutination) and the accumulation of sperm in clots is absent.
Leukocytes and red blood cells
Normally, there are no red blood cells in the ejaculate, and the number of leukocytes does not exceed 3-4 in sight. If there are more white blood cells, this indicates an inflammatory process in the male genital organs.
Normally there is no mucus in the semen or it is in a small amount. Detection of a significant amount of mucus suggests inflammation of the prostate and seminal vesicles.
- oligozoospermia – low sperm concentration;
- asthenozoospermia – low sperm motility;
- teratozoospermia – a reduced number of morphologically normal forms;
- azoospermia – no sperm in the ejaculate;
- aspermia – no ejaculate;
- oligospermia – the amount of sperm is less than 2 ml;
- leukospermia – an increased number of leukocytes;
- Akinospermia – all sperm are immobile;
- cryptospermia is a very low sperm content, which is determined only after centrifugation of the ejaculate.
In addition to eliminating inflammatory and endocrine diseases, the treatment of which is prescribed by a doctor (antibiotics and hormones) to improve the quality of sperm, you must follow simple rules:
The testicles are the only organ that is located outside the abdominal cavity. Therefore, heating of the testicles contributes to the deterioration of sperm quality: the activity of sperm cells decreases and pathological morphological forms appear.
Accordingly, it is necessary to abandon the frequent intake of hot baths / showers, less often to visit the bath and sauna, to give up the pleasure to soak in the Jacuzzi.
In addition, clothing (underwear and pants) should be free, do not squeeze the testicles and do not overheat them. It is recommended to abandon tight-fitting pants, tight jeans.
Stressful situations “hit” not only on the nerves, but also on sperm. If possible, you should avoid conflicts, overwork, nervous tension.
Equally important is the rhythm of sex life as sperm. Too rare sexual intercourse leads to a decrease in sperm motility, and, on the contrary, frequent intimate contacts make the sperm “liquid”, that is, the content of sperm in it is significantly reduced.
The optimal rhythm of sexual life is 4-6 times a week.
Weight and sport
Overweight is the accumulation of an excess subcutaneous fat layer that produces estrogens, which negatively affects the activity of sperm.
Normalization of weight will help a balanced diet and regular (2-3 times a week, moderate exercise). Especially useful physical exercises aimed at strengthening the muscles of the pelvic floor and abdominals.
It is necessary to abandon semi-finished products and products that contain preservatives and flavor enhancers.
Food should contain foods that contain large amounts of vitamins E, groups B, C, and trace elements selenium and zinc.
These biologically active substances have a beneficial effect on the quality of sperm.
The list of products should include seafood, greens (dill, parsley, cilantro, celery), carrots, pumpkin, garlic, asparagus, tomatoes, pomegranates, apples, bananas and avocados.
Also, the diet must include milk and dairy products, beef and veal, fish, nuts in large quantities, mushrooms, buckwheat, oatmeal, liver and legumes.
Very negative influence on the number and activity of sperm is affected by bad habits. You must stop smoking and drinking alcohol (or at least reduce the amount), especially beer, which contains large amounts of phytoestrogens.
And, of course, a complete rejection of drugs. The same applies to the excessive use of strong tea and natural coffee. These drinks are best replaced with fresh juices and mineral water.
Normalize the environment around is not under the power of one person, but you can minimize the impact of harmful factors. You should not keep your laptop on your lap (overheating of the testicles), try to reduce contact with toxic substances (varnishes, paints, household chemicals and other “harmful”), often breathe fresh air.
Almost 50% of men have certain deviations from normal semen reading. Some of them are enough to adjust the regime of the day and rest, rationalize food, give up bad habits – this improves the quality of sperm and increases fertility (fertility).
But in some cases, only IVF will help to conceive a child, the procedure of which involves the selection of active and without pathological deviations from the sperm morphology.
In case of pathological results of spermograms (presence of azoospermia, teratospermia, necrospermia, asthenozoospermia, and others), the IVF procedure is extended, ICSI becomes one of the stages.
ICSI is an assistive technology and consists of several stages:
- viable sperm production from the testis using microsurgery;
- sperm cultivation;
- selection of the best and most active sperm;
- sperm injection by intracytoplasmic injection into the egg;
- freezing of the remaining viable sperm cells for the future.
In addition to abnormal sperm analysis, ICSI is carried out in the presence of antisperm antibodies, both in a woman and a man.
The prognosis after the IVF procedure in conjunction with ICSI depends on two factors. First, the chances of fertilizing an egg are increased when active, viable spermatozoa are obtained from the testicle or ejaculate. And secondly, the higher the quality of eggs received from a woman, the higher the percentage of their fertilization.
During ICSI, fertilization of eggs occurs in 60-70% of cases, which is significantly higher (by 30%) during the standard IVF procedure.
In addition, an embryo develops in 90-95% of fertilized eggs.