Semen analysis (sperm count test)

Semen analysis (sperm count test)

The status of spermatogenesis evaluated by semen analysis (sperm count results). To obtain the correct spermiological diagnosis requires the following conditions for collection of the ejaculate:

• abstinence from ejaculation for 2-7 days (optimal period is 4 days)
• abstinence from ingestion of alcoholic beverages, including beer, potent drugs (hypnotics and sedatives) during this period
• abstaining from visiting saunas, as well as hot tubs for 2-7 days

The table shows the rate of spermiological WHO indicators (4th edition). Semen analysis results are always evaluated comprehensively.

Indicators of semen analysis, their norms and deviations comment:

Semen parameters	WHO standards	Indicator value
Period of abstinence	2-7 days	Failure to comply with the terms of abstinence, the analysis result can not be compared with the benchmark, and spermiological diagnosis in this case should be considered as incorrect. The average time of abstinence are optimal for the study of ejaculate. Re-analysis should be taken with the same time of first abstinence.
Amount	2 ml and more	Ejaculate volume less than 2 ml qualifies as micro-sperm, which in most cases is associated with inadequate function of the accessory genital glands. The upper limit of the volume of ejaculate by WHO guidelines is not limited.
Colour	Grayish	Red or brown color indicates presence of blood that may be caused by the presence of tumours, stones in the prostate or trauma. Yellowish can be a normal variant or indicate the disease with jaundice or taking certain vitamins.
pH	7.2 and more	Only lower value of pН is limited by WHO experts.
Thinning time	Up to 60 min	The increase of the period of thinning, as a rule, is a result long current inflammatory processes in the accessory sex glands such as prostate, seminal vesicles (vesiculitis), or enzyme deficiency.
Viscosity (consistency)	Small individual drops (up to 2 cm)	The reasons for the increase of viscosity are the same as with increasing time of thinning. In a normal ejaculate, emerging from the pipette, forming small individual droplets, and the sample with abnormal viscosity forms a thread more than 2 cm.
The density of sperm	20 million and more	Increase or decrease in the density of spermatozoa is defined as polyzoospermia or oligozoospermia respectively. The upper normal value of spermatozoa density is not limited by WHO experts. Changes in the density of spermatozoa are the result of endocrine disorders, blood flow disorders in the organs of the scrotum, or radiation toxic effects on the testis (reinforcing or depressing spermatogenesis), inflammatory processes and less — impaired immunity.
Total sperm count	40 million and more	The reasons for non-conformity are the same as in the previous paragraph.
Sperm motility 1. Active-moving with rectilinear motion (А) 2. Slow-moving with rectilinear motion (B) 3. Slow-moving with oscillatory or rotational motion (C) 4. Motionless (D)	type А > 25%, or А+В > 50 % after 60 min. after ejaculation	Reduced sperm motility called asthenozoospermia (or asthenospermia). Asthenozoospermia may be due to toxic effects or radiation, inflammation or immunological factors. Also matters environmental conditions. Asthenozoospermia (or asthenospermia) is often seen in people working under high temperature conditions (cook, attendant, employee of the "hot shop", etc.).
Morphology	More than 15%	Morphologically normal sperm cells constitute 40-60%.
Live sperm (sometimes - dead sperm)	More than 50%	The contents in the ejaculate more than 50% dead sperm called necrospermia (or necrozoospermia). Necrospermia, as well as the deterioration of the morphology, often of a temporary nature. Possible causes of necrospermia (or necrozoospermia) — poisoning, infectious disease, stress, etc. Long existing necrospermia evidence of severe disorders of spermatogenesis.
Spermatogenesis cells (immature germ cells)	No percentages standards	Found in each ejaculate. A significant number of germ cells (epithelial desquamation), occurs in the secretory form of infertility.
Sperm agglutination	Normal shouldn't be	True agglutination is rare and evidence of disorders in the immune system. Should be distinguished from true agglutination aggregation of sperm. Unlike aggregates, while true agglutination only the sperm stick together and "socket" from them do not contain cellular elements.
White blood cells (WBC)	1*106 (3–4 in a standard field of view)	The excess indicates the presence of inflammation in the genitals (prostatitis, vesiculitis, orchitis, urethritis, etc.).
Erythrocytes (RBC)	Normal shouldn't be	The presence of red blood cells in the semen may be associated with tumors, injuries of the genital organs, the presence of stones in the prostate, vesiculitis.
Amyloid corpuscles	No WHO standards	Referred as "Present/absent (+/-)". Amyloid corpuscles not currently present in many patients, indicating a reduction in prostate gland function.
Lecithin grain	No WHO standards	Referred as "Present/absent (+/-)". A small amount of lecithin granules indicates a decline in the functions of the prostate gland.
Mucus	No WHO standards	May be present in the norm. A large amount of mucus indicates possible inflammation of the accessory genital glands.