Before talking about pathology, you need to know what the norm is. Normospermia is not a diagnosis, but a normal state of ejaculate. To do this, it must meet certain parameters. These parameters are determined by the World Health Organization and are one for the whole world. Accurate quantitative indicators help to avoid a subjective assessment of the state.
Spermatozoa are produced in the epididymis and stored in it as a concentrated substrate. During ejaculation, this substrate is diluted with the secret of the prostate and seminal vesicles, the amount of which will determine the total volume of the ejaculate.
If the spermogram shows abnormalities, it is necessary to repeat the analysis after 2-3 months. The fact is that, as in any living organism, the state of the reproductive system is constantly changing. In addition, the quality of the collected ejaculate depends on external conditions, such as:
- Whether the ejaculate is collected completely. In the first portion of his sperm concentration is higher than in subsequent, so if it is lost, the result may be underestimated.
- The time elapsed from the last sexual activity. During ejaculation, the epididymis is not completely emptied. The accumulation of aging sperm cells can distort quality indicators.
Therefore, it is necessary to prepare for delivery of the ejaculate for analysis: sexual abstinence should not be less than 2 days, but not more than a week; 2-3 days before the study should avoid alcohol; Do not visit the sauna and do not take hot baths on the eve of the analysis (see details on preparing for the spermogram ).
If an ejaculate sterility test is needed, it is necessary to urinate before performing it, then wash the hands and penis with soap and dry them with a disposable towel.
Determined visually within 30-60 minutes after receiving the sample.
Immediately after ejaculation, the ejaculate is quite dense. Being in a container, it becomes more and more watery, and after 15-60 minutes turns into a homogeneous mass. Insufficient dilution capacity may limit sperm motility.
The viscosity is estimated by dialing the liquefied ejaculate into the pipette. Normally, it should be separated by separate drops, with a high viscosity a thread is formed. The change in viscosity may indicate a violation of the function of the secretory glands.
Normally, the ejaculate is grayish in color, uniform, slightly opalescent. Color may change due to impurities (pus, blood), transparency decreases with decreasing sperm concentration.
The total volume of ejaculate reflects the secretory activity of the prostate and seminal vesicles. The minimum allowable volume is 1.5 ml. A decrease in volume may indicate both incorrect collection of the ejaculate and obstruction (obstruction) of the vas deferens. Excessive volume -> 5 ml is possible in the inflammatory process with the release of exudate (inflammatory fluid). That is why the volume of sperm as an independent indicator is not considered, but is taken into account only in conjunction with the other data.
The secret of the seminal vesicles is alkaline, the secret of the prostate is acid. pH reflects the ratio between their activity, and normally above 7.2. A decrease in this indicator in combination with a small volume of ejaculate (oligospermia) and a reduced number of spermatozoa may indicate obstruction of the vas deferens or underdevelopment of the seminal vesicles.
Sperm agglutination - fusion of live sperm among themselves.
Fig. 1 - The degree of sperm agglutination.
Most often indicates that the causes of infertility - immunological. In order to confirm this, tests for antibodies are carried out (MAR-test or test for immunogenicity of motile spermatozoa with adhered particles). If more than 50% of motile spermatozoa are coated with antibodies, we can speak of an autoimmune process.
Cells other than sperm
The content of urogenital epithelium cells, leukocytes, and immature germ cells is of clinical importance. Immature germ cells can appear if the testicular tissue is damaged.
Leukocytes should be no more than 1x10 6 per ml. An increase in their number indicates an inflammatory process.
Determines the possibility of pregnancy. Motile sperm must be at least 40% of the total, at least 32% of spermatozoa must actively move: linearly or in a circle with a large radius.
Under the viability imply the number of sperm with an intact membrane. Normally, more than 58%.
In 1 ml of ejaculate should be more than 15x10 6 sperm. In the whole volume of their ejaculate should be> 39x10 6
Spermatozoa with a normal structure should be at least 4%. If this figure decreases, they speak of teratospermia ( teratozoospermia ) - a violation of the formation of spermatozoa.
Peroxidase positive cells
The peroxidase test is used to distinguish immature spermatozoa from leukocytes — both cells have a rounded shape. Leukocytes are able to secrete peroxidases - peroxidases, that is, the number of peroxidase-positive cells is the number of leukocytes. As already mentioned, there should be no more than a million (1x10 6 ) per ml.
In order to determine the secretory activity of the prostate, seminal vesicles and epididymis, determine the content in the semen of certain chemicals.
- The state of the prostate is indicated by the amount of zinc - normally> 2.4 mmoles in the ejaculate.
- The function of the seminal vesicles reflects the level of fructose> 13 μmol;
- The secretory ability of the epididymis characterizes the content of neutral alpha-glucosidase> 20 international units (IU).
Despite the fact that each parameter that determines the normal state of the ejaculate - normospermia - has an exact numerical value, the result of the study is evaluated exclusively in the complex. Therefore, only a doctor should make conclusions about the presence of a particular pathology and tactics of further patient management.
Watch a video about sperm performance