SPERM TEST FAQ

• At least 2 cc (or ml, for milliliters) – about half a teaspoonful – is considered normal. Too little semen may not allow the sperm to reach the entrance to the uterus which they must enter in order to get to the fallopian tubes.

• The volume may be low if a man is anxious when producing the specimen, if all of the sample is not caught in the collection container, if there is blockage of the channels that lead from the testicle to the tip of the penis, or if the man is dehydrated at the time of semen collection.

• The volume is measured by transferring the sample from the specimen cup directly into a test tube with volume markings. Marks along the side of the test tube indicate how much fluid is present.

• Average sperm count is at least 20 million cells per milliliter of semen (20m/ml) in men who are younger than 40.

• Counts of less than 20m/ml are considered sub-fertile.

Count per millimeter

• Sperm count is measured by placing drops of semen on a counting slide called the makler chamber which has a grid of 100 squares. The chamber is then viewed under a microscope.
• The total number of sperm (moving or not moving sperm) in a square is counted and recorded.
  The number of sperm in each square of the grid is often different. The technician counts the number of sperm in several grids and the average of those numbers is used to determine the count per millimeter.

Total sperm count

• The total sperm count is the count per millimeter times the volume of sperm.
• For example. If the count per millimeter is 30, and the volume is 3 ml, its total count will be 90million.
• This number includes both moving and non-moving sperm cells.

Quality of movement

• Ideally 50% of the sperm cells seen under the microscope should be moving rapidly (motility) in a forward direction (quality).

• When many sperms are not moving or moving very slowly, this may indicate an abnormality in the sperm tail or excess thickness of the seminal fluid which interferes with sperm movement.

• Motility is measured by counting the number of moving sperm and non-moving sperm when doing the sperm count.

  For example, if the sperm count is 60 million per ml and 30 million of the sperm are not moving, then motility is 50%.

Progression

• Normal healthy sperm cells are able to move forward quickly in a straight line. This is a rather subjective test. However, the desired progression should be at least 2+ or higher in a scale of 1+ to 4+.

• Describes the shape and size of sperm cells when seen under a powerful microscope.
• Sperm cells that have normal oval head shapes and
• Rapid tail motion are understandably the best able to penetrate the egg cell so fertilization can occur.
• The morphology examines if there are any abnormalities in the three major parts of the sperm cell, the head, mid-piece and the tail.
• Mild abnormalities are rather common and usually do not affect the ability of sperm to fertilize the egg. Other abnormalities however, may adversely affect the ability of sperm – such as duplicate head, so morphology is a very important aspect of the sperm analysis.
• Morphology or sperm shape can be measured by two methods:
  1. Who (world health organization)
  2. Kruger of strict morphology
• Strict criteria to assess sperm morphology was first reported by dr. Kruger in the 1970s.
• The kruger criteria is referred to as strict criteria because it uses more specific guidelines to evaluate the sperm head, mid-piece and tail. Multiple studies have shown that morphology determined by strict kruger criteria is a more useful and reliable way to distinguish between fertile and sub-fertile men than the who criteria
• The sperm sample is considered sufficiently ‘fertile’ if at least 14% of the sperm have normal shapes by strict criteria. Most men, even those who have had several children, do not often have normal kruger morphology. That is 30%.
• A patient is considered to be sufficiently fertile if over 4% of the sperm are normal by strict kruger morphology, especially if the count motility and volume are within normal range and the female partner has no significant fertility problems.
• A drop of semen is spread on a glass slide in a thin layer and allowed to dry over several minutes. The sperm cells are easily seen individually and are not moving. The slide is then stained with special solution and this dye is absorbed by all of the sperm cells. This
• Allows the technician to clearly see the outline of the head, mid-piece and tail of each sperm cell. Carefully observing the outlines of multiple sperm cells, measurements are made of the head shape, mid-piece and tail. These findings are reported on average of normal sperm.
• For example, if only 4 out of 100 sperm are totally normal, having no defect, this will be 4% normal morphology.

• Normally, semen is a thick whitish liquid. However, several conditions may affect and change the color and consistency of semen. Watery semen can be a sign of low sperm count, indicating possible fertility problems.

• Viscosity is the time it takes for the semen to fully liquefy. The semen sample is initially thick and somewhat viscous. If the seminal fluid is thick, it is understandably more difficult for the microscopic sperm cells to move and travel quickly. The ideal viscosity is 1+ on a scale 1+ to 4+. Liquefaction is usually complete within 10 to 30 minutes.

• The seminal fluid is usually alkaline(basic) not acidi. The normal semen ph is usually the range of 7.2 to 8.0.

• In order for a sperm to move through to the cervix opening, to the uterus and then into the tubes, they must be able to move quickly. When sperms are stuck together (agglutinated), they understandably cannot.
• Two or more sperms can be stuck together at the head or tail. If there is significant agglutination, this should be evaluated and can be a cause of unexplained infertility.

• The time for seminal fluid to change in consistency from the gel-like ejaculate to a more liquid form

• White blood cells are part of the immune response to infections. Under the microscope, it is normal to find 1-10 white blood cells per high power field. The presence of over 10 white blood cells may but always indicate that there is an infection.

• The presence of many round cells may represent either immature sperm (spermatocytes) that have not yet developed a tail or white blood cells (leukocytes).
• Round cells are not able to fertilize the egg.