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The EmbryLife Center offers a whole range of services for diagnostics and treatment of both female and male infertility. Our specialists use American IVF technology: we work according to guidelines that have shown proven results in thousands of US patients. This technology has implicit excellent laboratory equipment capabilities, in strict compliance with ASRM (American Society for Reproductive Medicine) and ESHRE (European Society of Human Reproduction and Embryology) requirements.

EmbryLife is the only clinic in Russia that has been accredited by the American Association of Embryologists.

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35 Sadovaya St., St. Petersburg, Russia

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Sperm analysis. Sperm analysis standards.


Worldwide reduction in sperm quality

According to the results of sperm analyses conducted in Europe, in the last 50 years the quality of sperm has changed not for the better. The ejaculate volume decreased one and a half times, and the spermatozoa concentration - almost two times. Moreover, even in healthy men, significant variations of sperm parameters have been reported, which reduces the probability of fertilization. Spermograms of a healthy fertile-age man were studied for two years, with weekly ejaculate collection and exclusion of unfavorable factors. The results convincingly demonstrated a significant spread in spermatozoa concentration, up to abnormal levels. The general trend consists in “easing” of the levels.

the structure of the male reproductive system

Author Year Concentration, mln/ml Volume, ml Motility, %
Davis 1943 4 60 80
Sharren 1972 2 40 70
Eliasson 1981 2 20 50
Van Zyl 1976 2 10 30
Нормы ВОЗ 1999 2 20 50
Нормы ВОЗ 2010 1.5 18 32

Male infertility classification

Another classification subdivides male infertility as follows:

  • secretory male infertility (spermatozoa and sex hormone production disorder)
  • obstructive male infertility (spermatozoa transport disorder)

Male sperm testing. Sperm analysis.

The examination of a man usually starts with semen fluid analysis after preliminary preparation:

  • sperm analysis with morphology
  • MAR-test (presence of antisperm antibodies in the ejaculate).

Please note that one test is not indicative. That is, if any deviations are detected in the primary spermogram, the analysis is repeated three to four weeks later. The ejaculate is tested for volume, viscosity, acidity, concentration, total spermatozoa count and their motility. First of all the morphological examination determines the quality of actual spermatozoa from the viewpoint of fertilization activity, spermatogenesis cells and leukocyte count. 

Temporary deviations in the spermogram

Male infertilityIt should be recalled that even a healthy man may have temporary deviations in his spermogram parameters. In such a case, it is sufficient to adjust one’s day regimen, change diet, give up unhealthy habits, avoid stresses, and in the end, relax. Even improvement in the family microclimate may play a positive role. It should be known that a couple may only be considered infertile after one year of regular sexual activity practiced for conception on the favorable days.

If negative sperm analysis parameters are still found for long periods, this should prompt you to undergo additional laboratory and instrumental examination of the reproductive function. In a number of cases, it is possible to normalize spermatogenesis and the endocrine profile. This method is time-consuming, since the spermatozoa formation and development process takes 60 to 75 days on the average. In most cases, men are very sensitive about everything related to probable sexual-related problems. The denial of even the possibility of such problems and the attempt to avoid taking personal responsibility often creates additional obstacles. Anxiety grows, family conflicts increase, and precious time is lost. In such a situation, a lot depends on the woman as well, because she can help not only her man but also the specialists.

Poor sperm analysis parameters. Azoospermia.

Due to the achievements of contemporary reproductive medicine, poor sperm analysis parameters and even the absence of spermatozoa in the ejaculate resulting from various reasons are not a final sentence anymore. A real breakthrough was associated with the discovery of IVF and especially ICSI. Thanks to ICSI, men who were previously considered infertile can have children, if even single (!) spermatozoa are detected in them.

If no spermatozoa can be detected in the ejaculate, spermatozoa may be obtained by the following methods of testicular biopsy:

  • PESA — Percutaneous epididymal sperm aspiration
  • TESA — Testicular epididymal sperm aspiration
  • SPAS — spermatocele aspiration
  • RETA — rete epididymal testis aspiration

It may be optimum for your couple to use an ART-option, i.e., a donor program, if either spermatogenesis (spermatozoa production by the man’s body) is totally suppressed, or it is not indicated to the man to use his own sperm due to genetic reasons.

Spermatogenesis stimulation with drugs

In some cases, physicians try to stimulate spermatogenesis in patients with reduced sperm analysis parameters, which requires taking drugs for a period from six months to one year. Unfortunately, such treatment does not always result in a somewhat significant increase in spermatozoa count, and for a woman time is precious because of the ovarian reserve, etc.Therefore, the specialists at ART centers recommend not delaying in visiting a fertility specialist, if the man has problems with his sperm analysis parameters and his partner is older than 35.

Even if a man lives a healthy lifestyle, his body will inevitably undergo natural changes as he ages, leading to reduction in male fertility, i.e., reproductive capability. Therefore, if your family has encountered an infertility problem, it is necessary to acknowledge this fact and undergo examination without delay. There is no point in being shy or afraid or inventing reasons for delaying the visit to a physician.

Spermatozoon. Sperm analysis.

It should be remembered that the probability of the meeting of male and female cells depends on:

  • spermatozoa count
  • spermatozoa viability
  • spermatozoa structure

It is for assessment of these properties that the spermogram is analyzed. This will make it possible to answer the question: can the spermatozoon cover the distance to the cherished goal, i.e., the ovum? Imagine that after entering the female body, the spermatozoa cover a distance of about 20 to 25 cm to meet an ovum in the fallopian tube. From the viewpoint of the spermatozoon (based on its dimensions), it is as if we had to cover a distance of over 100 km, by swimming! And in case of the spermatozoon, everything is aggravated by the fact that it has only 3 or 4 days of energy reserves. The next issue is that this distance may turn into a line of immune barrier-related obstacles. The MAR-test makes it possible to assess the presence of immunological issues, the root causes of which may be prior infections or general diseases, or injuries.

Sperm analysis standards

Standards for ejaculate parameters according to the latest 2010 World Health Organization (WHO) guidelines

Ejaculate volume, ml

1.5 and more

Total spermatozoa count, mln

39 and more

Spermatozoa concentration, mln in 1 ml

15 and more

Total spermatozoa motility, %

40 and more

Spermatozoa with progressive movement, %

32 and more

Viability, %

58 and more

Morphology: normal forms, %

4 and more

Spermogram interpretation

Significant deviations in sperm parameters from the established standards were often found in men who have already proven to be able to have children. The reason is that the spermogram is a very dynamic measure that varies widely from one day to another or from one week to another. Its interpretation is very complicated, unlike the interpretation of, e.g., blood test results. A temporary deviation does not always mean pathology.

A sperm analysis has been performed. What comes next.

The next step following a thorough sperm examination is development of an individual treatment plan, including its duration. Options that may be required:

  • non-surgical treatment (medication)
  • surgical spermatozoa retrieval + ICSI + IVF
  • artificial insemination AI
  • in vitro fertilization (IVF) with the use of ICSI technology, i.e., injection of a spermatozoon into the egg (conducted under a microscope with very powerful magnification)

This should not be reduced just to reproductive issues. The fertility problem (spermatozoa quality problem) is sometimes just the tip of the iceberg. A poor spermogram is not only an indication for ART, but also a serious reason for focusing on the condition of the genital system. The production of sex cells is not the only function of the genital glands. And a failure in this process is just the first sign. This may be followed by diminished sexual activity, loss of interest in the opposite sex and sexual disorders. Therefore, it is important not to do things half-way. All the more so, if you notice painful sensations, lack of confidence or heaviness, changes in the size or appearance of the genitals, you should immediately visit a urologist. For it is a matter of your future, the future of your health and your family.

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