How to interpret a seminogram?
We help you understand this medical test, which examines a man’s sperm before starting treatment for assisted reproduction
When a couple goes to a specialist in assisted reproduction, the first step is to obtain an accurate diagnosis of their fertility. At this stage, both members of the couple are involved, and the medical examination of the woman is just as important as the man’s. In his case, the seminogram, or semen analysis, is the most common test.
“The seminogram is a basic study of a semen sample obtained by ejaculation which helps to define the man’s fertility potential,” explains Dr. Marta Trullenque, a specialist at Eugin Clinic. “This is a test to evaluate sperm quality according to reference values established by the World Health Organization in 2010,” she adds. Below, we give you the keys for interpreting it correctly.
1. Confirmation of results
First, we must be very clear about the fact that the results can vary from one test to another. For this reason, it is advisable to perform a second analysis between one and three months after the first. Thus, the results can be confirmed, whether they are positive or not.
2. Reference values
The values that are detailed in the seminogram are the following:
• Volume: a sample obtained from an ejaculate is considered normal when the quantity of sperm is equal to, or greater than, 1.5 milliliters.
• pH: measures the acidity or alkalinity of the sample and should be equal to, or greater than, 7.2. Alterations may indicate malfunctions in the prostate or seminal vesicles.
• Sperm concentration: is the number of sperm per milliliter and is expected to be 15 million or more per milliliter.
• Total number of sperm: in a normal sample there are at least 39 million sperm. Although this value is studied, sperm concentration is much more significant.
•Motility: this determines the motility of sperm and is classified into three types:
-Progressive motility: able to progress in their advance and, therefore, traverse the Fallopian tubes and reach the egg.
Non-progressive motility: they don’t progress in their advance and they move in circles.
-immotile: unable to move in any way.
According to the WHO, it is preferable that at least 32% of sperm show a progressive motility.
• Vitality: indicates the percentage of live sperm in the ejaculate, which should be equal to or higher than 58%.
• Leukocytes: a sample regarded as normal should not contain more than one million leukocytes, or white blood cells per milliliter. An excess may indicate an infection.
Other factors taken into account are morphology (at least 4% of sperm should have the shape accepted as normal), appearance (the sample must be homogeneous and grey-opalescent in colour) and viscosity (if very high, it may hinder sperm motility).
It is important to remember that even though the results may be less than satisfactory, there are still chances of getting pregnant, albeit fewer. “And, the other way round too, a normal sperm count does not guarantee pregnancy,” points out Dr. Trullenque.
3. Possible pathologies
In medical terms, if the test results are positive, we are talking about normozoospermia. When there are significant variations, we can find cases of azoospermia (absence of sperm in the ejaculate), oligozoospermia (concentration of sperm below the reference value), and necrozoospermia (amount of live sperm lower than the reference value).
Asthenozoospermia deserves a whole chapter to itself for being “the most common pathology” in the words of the Eugin specialist. In these cases, sperm motility is below the standard values, making it difficult to reach the egg and fertilize it.
Assisted Reproduction: solutions
Even when faced with this type of more severe dysfunction, assisted reproduction offers treatments to achieve pregnancy with the partner’s sperm, except in some very extreme situations of azoospermia or aspermia. When it really is not possible to use the partner’s sperm, there is always the option of using donor sperm to inseminate the woman.
“In any case – stresses Dr.Trullenque-, the likelihood of achieving pregnancy doesn’t only depend on the results of the seminogram, which handles reference values that are not necessarily definitive.” The medical history of both, the woman’s age or the length of time they have been trying to get pregnant are determining factors that complete a couple’s fertility map.