Interpretation of the Spermiogram

By: | Tags: | Comments: 0 | July 7th, 2018

Parameters.
Normal values (ranges) according to the WHO:
Volume (ml) Greater than 2 ml
pH >7.1
Sperm Concentration Greater than 15 million per ml
Total sperm in the ejaculate More than 39 million
Vitality of sperm more than 58% of live spermatozoa
Motility = or greater than 40%.
Progressive Motility % A+B (progressive fast and slow) = More than 32%.
Non-progressive motility (C) = or greater than 32%.
Morphology (shape of spermatozoa)
Normal % More than 4% of sperm have a normal shape
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Case example John:
Volume (ml) :2,6ML
pH 8.6
Sperm Concentration 10 million per ml
Total number of sperm in the ejaculate 25.6 million
Sperm Vitality: 65%? motionless, motility (D), special test with eosin is needed in a new semengram after 3 weeks, as they may be alive but immobile, after staining, the preparation is observed under the microscope and 100 sperm are counted. Note how many of them are dyed and how many have repulsed the dye. In this way we calculate the percentage of live and dead spermatozoa.
The World Health Organization (WHO) dictates that from 58% of live spermatozoa onwards, the semen sample is considered normal, while if the vitality index is lower, it is considered that many spermatozoa are dead and therefore there is an alteration in semen quality.
Motility:
Progressive Motility % : 27%
Non-progressive motility: 8%.
stationary: 65%.
Morphology (shape of spermatozoa)
Normal % More than 7% of sperm have a normal shape.
Abnormal spermatozoa: 65%.
If JOHN wants to get out of doubt, he should repeat the spermiogram after 3 weeks and request it with the sperm vitality test, asthenozoospermia is the most frequent pathology. In these cases, the mobility of the sperm is below the standard values, making it difficult for them to reach the egg and fertilize it.
In an artificial insemination, the best sperm are selected in the laboratory, those that move forward and fast, and are deposited beyond the cervical mucus, in the middle of the uterus, so they probably reach the end of the tube in about 10-20 minutes after insemination; when a man has problems with sperm mobility, he is diagnosed with asthenozoospermia or asthenospermia. It is a sperm alteration that we colloquially know as spermatozoa, slow or immobile.
The seminogram or spermiogram is the test in which the sperm is analyzed and, therefore, the one that allows us to study the movement of the sperm. During this sperm analysis, a drop of semen is deposited in the counting chamber , and under the microscope, the movement of approximately 100 sperm is recorded.
Asthenozoospermia is diagnosed when a large number of immobile sperm are observed, with slow or non-progressive movement in the semen sample.
Analysis of the movement of the spermatozoa
The WHO establishes some reference values to mark normality in relation to the semen parameter of mobility or motility of the spermatozoa: Values equal to or higher than 40% of mobile spermatozoa (progressive and non-progressive). Values higher than 32% of progressive mobility, i.e., capable of moving and advancing in distance with this movement.
Levels below these references are considered abnormal or causing asthenozoospermia.
Degrees of asthenospermia
Depending on the exact percentage of immobile sperm found in the sperm sample analyzed, we speak of more or less severe asthenozoospermia. We generally distinguish two degrees of gravity:
Severe or severe
It is diagnosed when the percentage of sperm with low or no mobility is very high. Although there is no specific value, we could say that we are dealing with a case of severe asthenozoospermia when the percentage of immobile sperm is close to 75-80% or higher. it is also important to highlight not only the total motility but also the type of mobility, because if there are very few sperm with progressive and rapid mobility, we will also talk about severe asthenozoospermia.
Slight to moderate
This degree is indicated when the percentage of sperm without mobility or with poor mobility is between 60 and 75%. As in the previous case, it is essential to consider the type of movement, because if there are few movements, but at least the movement of these is straight and allows progress, we can qualify it as mild asthenozoospermia, as we see, the gradation of asthenospermia is not defined. More or less severity will be indicated depending on the form and speed of movement and the number of immobile spermatozoa.

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