Spermiogram

Semen analysis: examination of the ejaculate

It makes sense to submit a semen sample before the first consultation in our Fertility Centre. We will examine this sample so that we can identify a possible reason why your desire to have children has not been successful and so we can discuss a treatment with you.

Please arrange an appointment in our Fertility Centre for the spermiogram. The semen sample should be delivered after two to seven days of sexual abstinence.

If you are not able to ejaculate in the Fertility Centre, under certain conditions you can also bring some from home. In this case you must ensure that the transport to our fertility centre takes place at body temperature within half an hour. We will provide you with suitable containers to collect the semen.

If you are with a statutory health insurance company, there will be no costs for the spermiogram (including blood sample) For privately insured persons, costs accrue in accordance with the German Scale of Fees for Physicians.

Why is the sperm impaired?

There are many reasons why the sperm could be impaired? A distinction is made between production disorders (in the testes, sperm are not produced in sufficient quantities or defective sperm are produced) and transport disorders (sperm cannot get to the outside through ejaculation, because the sperm ducts are closed).

Possible causes could be:

  • Undescended testicles as a young boy
  • Mumps
  • Unhealthy lifestyle (nicotine, alcohol, obesity)
  • Medication
  • Varicose veins on the scrotum (varicocele)
  • Genetic causes
  • Blockage of the semen ducts (due to infections, hereditary)

Which criteria are used to assess the sperm?

It is checked whether sufficient numbers of motile sperm are present (normozoospermia), or whether too few sperm are present (oligozoospermia) or whether the sperm do not move enough (asthenozoospermia). In addition, the shape (morphology) and the maturity of the sperm, as well as inflammation parameters, are examined. An antibody test is carried out (MAR test). Furthermore, a microbiological examination of the ejaculate (for specific bacteria) is completed.

The evaluation of the sperm takes place in accordance with the 2010 WHO (World Health Organisation) reference values.

The following technical terms are used:

Normozoospermia = normal spermOligozoospermia = too few sperm (fewer than 15 million sperm per ml of ejaculate or total sperm count below 39 million)Asthenozoospermia = reduced mobility (fewer than 32% of the sperm are forwardly mobile)Teratozoospermia = reduced proportion of normally shaped sperm (less than 4% normally shaped)Oligo-Astheno-Teratozoospermia = all three parameters (concentration, motility and shape are impaired)Azoospermia = no sperm in the ejaculateParvisemia = volume too low (less than 1.5 ml)

Because the sperm quality is subject to considerable fluctuations, it makes sense to submit a second semen sample about 6-8 weeks later, in order to confirm the result.

What can be done when there are too few sperm or none at all? 

If there are few sperms or if the sperm are not sufficiently motile, they can be directly transferred into the womb with a small plastic syringe (intrauterine insemination).

If there are too few motile sperm for this, then there is the option of fertilisation outside of the body (IVF/ICSI).

If there is no sperm at all present in the ejaculate, then a small operation can be completed on the testis, in order to remove a testicular sample (TESE). Frequently, sperm are found in the testis that can be used for fertility treatment

If no sperm are found in the testis either, there is, an alternative option to become parents: As a married couple, you can consider whether you wish to use donor sperm (donor IUI).

How can the sperm improve?

  • Don’t smoke
  • Reduce alcohol consumption
  • Healthy diet
  • Regular exercise
  • Normal body weight

After the diagnosis of “azoospermia”, we had almost given up our dream of having children. The Dortmund Fertility Centre gave us courage and after successful TESE followed by ICSI treatment we became the happy parents of a boy. Some time later, we then had another treatment with the frozen embryos, which gave our son a healthy sister.

Verena S.

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