The spermiogram evaluates the health and vitality of the spermatozoa . Sperm is the liquid containing spermatozoa (as well as sugars and protein substances) that is released during ejaculation. A spermiogram evaluates three main factors :

• The number of spermatozoa

• The shape of the spermatozoa

• The motility of spermatozoa

Doctors often perform two or three separate spermiograms in order to better assess the health of the sperm. The exams must be repeated at an interval of at least 14 days from each other. The result, in fact, can vary from day to day.

How to prepare for the spermiogram

It is very important to follow these instructions carefully to get an accurate result.
The indications for obtaining an optimal sample are:

• abstention from ejaculation 24 to 72 hours before the exam

• do not take alcohol , caffeine and drugs 2 to 5 days before the exam

• avoid taking hormones

• inform the specialist if you are taking any medications

What are the normal results?

The specialist will evaluate the following results:

Concentration
The concentration, which indicates the number of spermatozoa present per ml of ejaculate, should range between 15 and 213 million. The total number of spermatozoa in the ejaculate should be equal to or greater than 39 million.

Motility
There are 3 types of sperm motility:

• progressive motility (PR)

• non-progressive motility (PN)

• immotility (IM)

Under normal conditions, the percentage of spermatozoa moving with progressive motion (PR) is greater than or equal to 32% and the percentage of total motile spermatozoa (PR + NP) is greater than or equal to 40%.

Morphology
The percentage of morphologically normal spermatozoa is greater than 4% . The spermiogram can detect abnormalities in the head, midfoot, or tail of the sperm. It is also possible that the spermatozoa are unable to fertilize the egg because they are not mature.

Volume
Under normal conditions, the semen volume should be greater than 1.5 mL . Poor sperm volume may indicate too low a sperm count to fertilize the egg. Even an excessive volume of the ejaculate could be negative, causing a dilution of the amount of sperm present.

Appearance

The appearance of the sperm should be opalescent gray. A brownish semen may indicate the presence of blood, a yellowish color may indicate jaundice or be a side effect of some drug.

pH
The pH level must be between 7.2 and 7.8 . A pH level above 8 can indicate that the donor has an ongoing infection. A result below 7.0 may, on the other hand, indicate sample contamination or an obstruction or absence of the ejaculatory ducts.

Fluidification
The semen liquefaction process should take between 15 and 30 minutes . Failure to liquefy semen within 30 minutes could compromise fertility.

Commonly used terminology

• Normozoospermia : normality of seminal parameters

• Oligozoospermia : sperm concentration <15 million / mL or total number of spermatozoa in the ejaculate <39 million

• Astenozoospermia : <32% of sperm with progressive motility (PR)

• Teratozoospermia : <4% of spermatozoa with normal morphology

• Oligoastenoteratozoospermia : alteration in the number, motility and morphology of spermatozoa

• Oligoteratozoospermia : alteration in the number and morphology of spermatozoa

• Oligoasthenzoospermia : alteration in the number and motility of spermatozoa

• Astenoteratozoospermia : alteration of motility and morphology of spermatozoa

• Cryptozoospermia : absence of spermatozoa in the ejaculate, but presence of sperm cells after centrifugation

• Azoospermia : absence of spermatozoa in the ejaculate even after centrifugation

• Hypoposia : reduced volume of seminal fluid

• Hyperposia : excessive volume of seminal fluid

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What does an abnormal result imply?

Sperm with abnormalities may have problems reaching and / or penetrating the egg, thus preventing conception.
If on repeating the test the result still shows abnormalities, the specialist may suggest that you perform other tests, including:

• hormonal dosage

• scrotal ultrasound

• sperm DNA examination

• genetic tests

• testicular biopsy

• seminal fluid immunoassay

Sperm DNA Fragmentation Test

The sperm DNA fragmentation test is a second level examination that allows to highlight the lesions or ruptures of an individual's sperm . It is a useful tool for diagnosing and treating infertility-related problems that would once have been referred to as "idiopathic," ie without explanation.

Recent studies have shown that up to 80% of men with unexplained infertility have problems with their sperm DNA , which can only be detected with a DNA fragmentation test. Factors such as stress, smoking, alcohol, drugs, obesity, and other lifestyle issues can have a negative impact on the quality of semen.

Why take the test?

Damage to sperm DNA has not only shed light on the diagnosis of unexplained infertility, but has recently also been associated with recurrent miscarriage conditions. A detailed analysis of sperm DNA damage can provide specialists with the tools they need to treat the problem and assist the patient with therapy that makes a difference.

For example, it is possible to reduce sperm DNA damage by making simple lifestyle changes, by reducing the consumption of alcohol, drugs or smoking.