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Semen analysis

A semen analysis (Spermiogram) is a basic method of diagnosing male fertility. It determines whether a man is fertile – able to get a woman pregnant. The semen analysis consists of a series of tests that evaluate the quality and quantity of the sperm and determines possible causes of infertility.

Methods of semen testing

CASA (Computer Assisted Semen Analysis) – supported by automatic system SCA (Sperm Class Analyzer) analyzes semen under microscope, determining its concentration (counts), motility (movement), and morphology (shape and appearance). It also limits possibility of laboratory mistake to minimum.

MSOME (Motile Sperm Organelle Morphology Examination) – is the analysis of the sperm morphology wherein an inverted light microscope equipped with high-power optics and enhanced by digital imaging is used to achieve a magnification above x6000-8000. It allows to evaluate spermatozoa from the morphological perspective. Evaluation of the quantity of vacuoles allows to determine potential abnormalities of cells chosen for ICSI/IMSI procedure. Research confirms that spermatozoa which were chosen for the IVF procedure based on MSOME examination increase chances of fertilization, enhance quality of obtained embryos, and have influence on its successful development.

Sperm DNA Fragmentation
Examination of sperm DNA fragmentation, called  SCD (Sperm Chromatin Dispersion) analyzes what percentage of the sperm is damaged. The sperm with high DNA fragmentation significantly decrease chances of fertilization, and might cause abnormalities at the very early stage of embryo development what may result in implantation failure and increase likelihood of miscarriage.

Indications for male patients:

  • unexplained infertility
  • advanced age (over 45 years old)
  • arrested embryo development
  • multiply failed of in Vitro treatment
  • recurrent miscarriage
  • poor semen parameters
  • exposure to harmful substances

 

How to prepare for semen analysis?

To get the most accurate result it is recommended to avoid ejaculation, alcohol, caffeine, and any herbal or hormone medications for 3-5 days before the test.


How is semen analysis conducted?

The patient comes to the Clinic at the scheduled time and provides a semen sample in a special room where he can be with his partner. Semen can be collected by masturbation into a sterile container or using a special condom (Male-FactorPak).

The Male-FactorPak Semen Collection Condom is used to collect the semen sample for the semen analysis by intercourse and not by masturbation. The condom is made out of special material and do not contain substances toxic to sperm. Moreover, the condom maintains the semen parameters and does not influence semen analysis. The usage of The Male-FactorPak is accepted by WHO, and it is recommended to patients having problem with semen collection by masturbation in clinical conditions.


Semen analysis result

Semen parameters according to World Health Organization criteria (2010)

PARAMETR WHO NORM
Volume 1,5 ml
General sperm count 39 mln
Sperm concentration 15 mln/ml
Motility 40%
Progressive motility 32%
Viability 58%
Morphology 4%
Semen acid-base balance (pH) >= 7,2

 

Diagnostic procedures (PESA/TESA/TESE/MESA)

In case of azoospermia (zero sperm counts) or oligozoospermia (sperm count less than 1mln/ml) epididymal aspiration and testicular biopsy may be performed.


Types of epididymal aspiration & testicular biopsy
 

PESA (Percutaneous Epididymal Sperm Aspiration ) – the sperm is collected from the epididymis using a small needle inserted through the skin of the scrotum.

TESA (Testicular Sperm Aspiration) – the sperm is collected from testicular using the small needle to aspirate the fluid and tissue.

TESE (Testicular Sperm Extraction) – a small portion of tissue is removed from the testicle to extract the few viable sperm cells present in that tissue. This procedure is recommended to those men who cannot produce sperm by ejaculation due to azoospermia. It is performed under local anaesthesia and lasts around 30 minutes.  

MESA (Microsurgical Epididymal Sperm Aspiration) – a retrieval of sperm-containing fluid from epididymis. It is used for men having no sperm in their semen due to a blockage or absence of the vas deferens (the duct which conveys sperm from the testicle to the urethra). The procedure is performed under local anaesthesia and lasts around 30 minutes.  

 

Sperm retrieved during above-mentioned procedures can be used for in Vitro fertilization (ICSI/IMSI) or vitrified and stored at Gyncentrum International Sperm and Egg Bank.

 


Read more:

> Evaluation of ovarian reserve
> Fertility test

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