Spermogram The spermogram is perhaps the most valuable tool for male infertility assessment At least two samples must be tested by the laboratory to avoid misdiagnosis. Sexual abstinence 2 to 3 days prior to the analysis is recommended. Normal semen parameter values, according to the WHO (WHO manual, 5th Ed., 2010) are: Semen culture Imaging of the genital tract Hormonal profile Virological testing Genetic testingFertility Tests for Men
Liquefaction time
30-60 min
Semen volume
≥1.5 ml
PH
7.2
Sperm cell count
≥15.000.000/ml
Total sperm cell count
≥39.000.000
Sperm morphology (normal forms)
≥4%
Antisperm antibodies
≤50%
Round cell count
> 5.000.000
A culture of the seminal fluid is usually done during the investigation of infertility, in order to detect the presence of germs that may have infected the genital tract. The culture may be recommended after a spermogram, in which a large number of cells indicative of infection may have been observed. Semen culture is different from a spermogram. The man may produce a semen sample regardless of the duration of abstinence, and must also comply with specific instructions for collecting the sample. More specifically, the man needs to urinate first, then wash his genitalia thoroughly and wipe with a clean towel. The sample may then be collected into a sterile container. Then, the sample should be brought to the laboratory within three hours. Semen culture is a valuable test; it helps detect and treat several urogenital infections.
Several pathological conditions, more or less serious, affect the scrotum. Scrotum
During the infertility investigation of a man, it is essential to measure the blood levels of certain hormones; these may directly or indirectly affect sperm production. The main hormones to measure are: Testosterone, FSH, LH, prolactin, TSH, estradiol and cortisol. Investigating the male hormonal profile is important when examining why a man presents with a reduced sperm count, without any other apparent reason, such as varicocele, testicular cancer, ejaculatory duct obstruction etc..
During the infertility investigation of a man, the law requires both partners to be tested for important viruses. The tests required are: ΗΙV I & II HBsAg HCV and VDRL.
Men whose spermogram showed a low sperm count need to be karyotyped, in order to check for possible chromosomal abnormalities, such as Kleinefelter syndrome (46XXY).
