Spermiogram: Information & spermiogram specialists

A spermiogram involves checking various parameters of the male ejaculate. By comparing the data with standard values, it is possible to draw conclusions about his fertility.

Here you will find further information as well as selected specialists and centers for the preparation of a spermiogram.

What is a spermiogram?

A spermiogram is the result of an examination of the male seminal fluid (ejaculate). The ejaculate is checked for various standard values defined by the World Health Organization(WHO). The aim is to assess a man's fertility.

The standard values are globally valid guidelines for assessing and comparing the quality and quantity of sperm contained in the ejaculate.

The ejaculate is examined for various parameters. These include, for example

• the volume (quantity) and the pH value of the ejaculate,
• the sperm density,
• sperm motility (mobility),
• morphology (external shape) and
• vitality (liveliness).

Causes for a man's inability to conceive can include

• insufficient quality or
• too low a sperm concentration

be the cause.

When is a spermiogram performed?

There are various reasons for having a spermiogram performed. It is often an unfulfilled desire to have children that prompts couples to have their fertility checked. After one to two years in which no pregnancy occurs, a visit to the doctor is justified.

The cause of involuntary childlessness can be found in both the man and the woman.

The spermiogram provides information about possible infertility in the man. The couple concerned can then turn to artificial insemination methods such as

• insemination or
• in vitro fertilization

in vitro fertilization.

Pregnancy is often still possible with artificial insemination © koya979 | AdobeStock

A spermiogram can also be used to check the success of a vasectomy (sterilization). This gives the man absolute certainty about permanent infertility and thus the success of the procedure.

How is a spermiogram performed?

Spermiograms are usually carried out by experts in reproductive medicine and/or andrologists.

For a meaningful spermiogram, the man must not ejaculate for three days. He then provides a sperm sample by means of masturbation. This waiting period rules out any reduction in quality due to too short or too long abstinence. This makes the results comparable.

The ejaculate is delivered under aseptic conditions in a sterile container. The patient can give the semen sample to the expert on site in rooms provided for this purpose. If the patient is uncomfortable, this can also be done at home in familiar surroundings. However, the sample must reach the expert quickly afterwards. It should not be older than 30-60 minutes when the spermiogram is prepared.

A macroscopic and microscopic examination is then carried out. At the end of the examination, the semen quality is compared with the underlying WHO standard values. This provides reliable information about the patient's fertility.

What is examined in a spermiogram?

The first step in a spermiogram is a macroscopic examination. The seminal fluid is examined without the aid of a microscope. Among other things, the following are examined

• Volume,
• odor,
• color,
• viscosity and
• pH value

of the ejaculate.

This is followed by a more detailed examination under the microscope. In this microscopic examination, a small amount of the ejaculate is evaluated under standardized conditions using a microscope.

Among other things, the following are examined in detail

• total number,
• concentration and
• motility

of the sperm.

Stained sperm sample under the light microscope © Bobjgalindo - Own work, CC BY-SA 4.0, Link

Macroscopic analysis of the seminal fluid

The following characteristics are checked during the macroscopic examination:

• Liquefaction time: Shortly after exiting the seminal ducts, the ejaculate is initially viscous. It liquefies again after half an hour. If this liquefaction does not take place, this is referred to as a hyperviscosity disorder.
• Volume: According to the WHO, the volume should be at least 1.5 ml per ejaculation. Too little semen indicates a lack of seminal vesicle secretion. The seminal vesicle secretion normally takes up about 2/3 of the seminal fluid. The cause of an insufficient ejaculate volume may be blocked seminal vesicle ducts.
• Color: Healthy semen has a whitish cloudy color. Discoloration can have different causes: Yellowish indicates an infection. Reddish indicates the presence of red blood cells (erythrocytes). Brownish can indicate the presence of blood, for example.
• pH value: According to the WHO, the pH value of the seminal fluid should be between 7.2 and 8. If the value is higher, this may be the result of an infection. Lower values can result from a malformation or obstruction of the vas deferens, the seminal vesicle or the epididymis.

Microscopic analysis of the seminal fluid

As part of the microscopic examination

• the total number of sperm per ejaculate,
• the concentration of sperm per milliliter of ejaculate and
• motility (motility) and vitality (vitality).

It also examines

• how long it takes for the ejaculate to liquefy and
• what the external shape (morphology) of the spermatozoa looks like.

Infertility is ruled out if the seminal fluid meets the following standard values:

• The semen sample should have a total sperm count of 39 million sperm.
• The concentration of sperm per milliliter should be 15 million.
• The motility of the sperm should be at least 40 percent (total motility).
• 32 percent of the spermatozoa should be rapidly motile (progressive motility).
• The vitality of the sperm cells should be at least 58 percent.
• The time to liquefaction should be between 15 and 30 minutes.

All the values mentioned are minimum values.

Sperm cells also normally have

• an oval head,
• a short middle section and
• a tail

tail. A pathological sperm deviates from this norm in its external shape. For example, the head may be too small and there may be damage to the midpiece and tail.

In general, the proportion of normally shaped sperm must not fall below four percent.

Furthermore, according to the WHO, the seminal fluid should contain less than one million leukocytes (white blood cells) per milliliter. Leukocytes in the ejaculate can be the result of inflammation of the vas deferens.

Evaluation of a spermiogram

The results of the spermiogram are compared with the WHO standard values described to determine fertility. Normal fertility or fertility presupposes that the quality of the patient's seminal fluid corresponds to these values. If this is the case, unrestricted fertility is guaranteed.

Infertility can have various causes:

• A mumps disease,
• sexually transmitted diseases or
• injuries in the genital area

can have caused inflammation of the seminal ducts or cause them to become blocked. Varicose veins in the testicles can lead to overheating of the testicles. This leads to permanent damage to the sperm.

Environmental influences such as

• smoking,
• increased alcohol consumption and
• stress

also have a negative effect on sperm quality.

If a value that deviates from the norm indicates infertility, this does not necessarily mean anything. After about two months, the sperm is analyzed again. This can confirm or dispel any existing suspicion of impaired fertility.