The spermogram is a complementary diagnostic test that consists of the evaluation of sperm quality and that includes parameters such as sperm count, mobility and morphology.
What is a spermogram for?
“A spermogram is an analysis done on the sperm in which its characteristics are evaluated. This exam also serves to define which type of treatment is most appropriate for each case, depending on the cause of infertility ”, explains Sónia Bally Jorge, embryologist at the Center for Medically Assisted Procreation at Hospital Lusíadas Lisboa .
In which cases is a spermogram indicated?
The spermogram “is one of the first tests that is done” when there is a suspicion of infertility in the couple. “Usually, the couple goes to the fertility clinic because they want to get pregnant and are not getting it. The spermogram is done right at an early stage of the evaluation to detect any male infertility problem ”, explains the embryologist. This procedure is justified given the ease of performing the exam. “In laboratory terms it is a relatively easy test to do, although it requires a lot of experience from the technician.”
What precautions to take?
To perform the spermogram, “it is necessary to have negative virologies (analyzes of hepatitis B and C, HIV 1 and 2 and VDRL).” The man will be asked to have good hygiene of the genital area and to abstain sexually in the two to five days before the exam, which “is important to keep the quality of the sperm and the analyzes are comparable.”
How is the harvest done?
“The sperm is collected by masturbation into a sterile container, which is identified with personal data. The days of abstinence and the time of harvest are noted ”, explains Sónia Jorge. The collection is done, preferably at the hospital, since “the analysis must be carried out in a short time after the collection, under penalty of changing some parameters.” In the need to be performed outside our facilities, the sample must be delivered within one hour after collection.
What are the possible results?
In the spermogram, semen volume, ph and viscosity, concentration, mobility and sperm morphology are evaluated. Vitality can also be assessed when necessary and an immunological test carried out.
“The big parameters are volume, concentration, mobility and morphology. Based on these four parameters, we will define the treatment to be performed ”, contextualizes Sónia Jorge. The reference values were defined by the World Health Organization, as a result of a worldwide study carried out in 2010 with men who had been parents for less than 1 year:
- Volume:≥ 1.5 ml.
- Concentration:≥ 15 million sperm per milliliter.
- Mobility: ≥ 32% progressive sperm or 40% mobile sperm (includes progressive and non-progressive).
- Morphology:≥ 4% of normal forms.
Results are usually delivered within 48 hours.
What are the consequences of the main results?
The results of the spermogram can be varied depending on the result of each of the parameters. Sónia Jorge explains the meaning of the main scenarios:
“Ultimately, the worst result is an azoospermia situation in which sperm cannot be detected in the ejaculate. In these cases it is necessary to perform a testicular biopsy where sperm may or may not be found. As long as we have sperm, it is always possible to start an in vitro fertilization cycle . ”
“Having sperm with all normal parameters will be the best scenario, which may not guarantee a pregnancy. Likewise, although changes in sperm function can be detected, this in itself may not prevent pregnancy. In a couple where there seems to be no male factor, it may be necessary to assess the presence of female factors that affect fertility or situations associated with gametes may also be detected during IVF . For this reason, the fertility approach is always made in the context of the couple.