Infertility testing
Infertile relation =When a couple have regular, active sex life without the use of contraceptives and pregnancy doesn’t happen within 1 year – (WHO, 1995).
According to the latest surveys the desired pregnancy doesn’t happen within 1 year in 25% of relations in Europe. 15% of these couples seek medical help and 5% of them remain childless against their will.
The interrogation of men reporting for the examination on their previous diseases, surgeries, medications and possible environmental pollutants, life style factors is elemental concerning male infertility. It is followed by the physical examination of male genitals. The analysis of the sperm (spermatogram – microscopic and computer complete analysis based on WHO criteria) is the next. The analysis of spermatogram is adequate if abstinence from ejaculation for 3-5 days was maintained prior to the examination. The sample is collected in a sterile container. The sample may be analyzed following liquefaction (20-30 minutes) and it is advisable to start within 1 hour. If the spermatogram is pathologic hormonal treatment is applied depending on the result of the physical examination. Genetic testing may be required depending on the severity of changes or in case of multiple miscarriages. The function of organs participating in spermatogenesis (sperm production), obstruction of the male reproductive tracts or the effects of inflammation may be evaluated by the laboratory examination of biochemical markers. Diagnostic imaging (ultrasonography, CT, MRI) may be performed when required.
According to WHO criteria the spermatogram is classified as normal if corresponds to each of the following parameters
| Semen volume (mL) | 1,5 |
| Sperm count (106/ejac.) | 39 |
| Sperm concentration (106/mL) | 15 |
| Total motility (progressive+non-progressive %) | 40 |
| Progressive motility (pr.%) | 32 |
| Vitality (living sperm %) | 58 |
| Normal morphology (normal shape %) | 4 |
| pH | >7,2 |
| Peroxidase-positive leukocyte count (106/mL) | <1 |
| MAR test % | <50 |
Names of most common spermatogram abnormalities
| Low sperm count | oligozoospermia |
| Severely low sperm count | oligozoospermia maximalis |
| Absence of sperm | azoospermia |
| Poor sperm motility | asthenozoospermia |
| Sperms carry morphological defects | teratozoospermia |
| Only nonviable sperms | necrozoospermia |
If the spermatogram is pathologic hormonal treatment is applied depending on the result of the physical examination. Genetic testing may be required depending on the severity of changes or in case of multiple miscarriages. The function of organs participating in spermatogenesis (sperm production), obstruction of the ejaculatory ducts or the effects of inflammation may be evaluated by the laboratory examination of biochemical markers. Diagnostic imaging may be performed when required.
Spermatogram is analyzed with the most recent automated analyzer (SQA IV) which is supplemented by manual counting and performing peroxidase test.
