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Semen Analysis (spermiogram)

The detailed sperm analysis (spermiogram) is the most important examination in the case of infertility. The results obtained from sperm analysis allows us to recommend the right treatment for you. Based on the results we can advise you whether the semen is suitable for insemination (IUI), IVF or ICSI and what your personal success rates for each treatment are.  In our clinic, we treat each couple individually. We also select the diagnostic methods according to your personal history and your individual circumstances. For example, we perform sperm analysis differently in men with a high sperm count than in men with a very low sperm count. In addition to the basic sperm analysis, we simulate the conditions in which we would perform your future fertility treatment where we prepare the semen in the same fashion like we would do during the treatment. This provides us useful information on beforehand allowing us to prepare the best treatment conditions for you individually. Therefore, we prefer to personally examine the sperm before starting your treatment even if you already had several examinations done on beforehand. The final decision as to which fertility treatment is most suitable for you personally will only be made in combinations with your partner’s examination results.

How semen analysis performed?

Ideally, sperm analysis is performed after 2-5 days of sexual abstinence. It is possible to produce a semen sample either at our clinic or at your home (your journey from home to our clinic should take a maximum of 30 minutes to avoid false results). You can pick up a suitable non-toxic cup from us on beforehand.

What exactly is being investigated during semen analysis?

We assess the sperm sample macroscopically and microscopically according to the latest guidelines of the World Health Organization (WHO). Each parameter helps us to comprehend any possible hindrance and in which way precisely we can assist you to become pregnant. The following examinations are part of our standard sperm analysis.

 pH value

The normal pH range for semen can vary between 7.2 – 8.0. A pH outside this range may indicate an infection or disturbance of the seminal vesicles and should be further investigated by a urologist.

 Viscosity

The ejaculate contains enzymes that liquefy the sperm under normal conditions, allowing the sperm to move freely after about 20 minutes. Increased viscosity affects your fertility and needs special treatment.

 Microscopic examination

The microscopic examination of the sperm is carried out at the cellular and molecular level after different staining and state-of-the-art biochemical tests.

 Sperm concentration

Sperm concentration is the number of sperm per milliliter of ejaculate. The normal value is at least 15 million sperm/ml. There should be a total of at least 39 million sperm in the entire ejaculate in order to conceive naturally. Therefore, not only the sperm concentration per milliliter, but also the total sperm concentration in the ejaculate is very important for the evaluation of the semen. With low sperm concentration and only a few normal-shaped sperm, ICSI treatment is usually recommended.

 Sperm concentration

Sperm concentration is the number of sperm per milliliter of ejaculate. The normal value is at least 15 million sperm/ml. There should be a total of at least 39 million sperm in the entire ejaculate in order to conceive naturally. Therefore, not only the sperm concentration per milliliter, but also the total sperm concentration in the ejaculate is very important for the evaluation of the semen. With low sperm concentration and only a few normal-shaped sperm, ICSI treatment is usually recommended.

 Sperm motility

Sperm motility is the ability of the sperm to move forwards categorized according to their speed. There are fast sperms (A), slower moving sperms (B), sperm which move in their location but not forwards (C) und non-motile sperm (D). There should be a minimum of 32% A- und B-sperms within the ejaculate. All these parameters require special attention for your tretament planning.

 Morphology

Morphology evaluates the sperms microscopically for normal shaped sperm. According to the newest WHO guideline strict crieteria a minimum of 4% of nomal formed sperms has to be present for a natural concepttion to occur. If these strict criteria get applied to the analysis there are only very rarely sperm samples that show more than 5-6% normal shaped sperm.

The precise assessment of the exact sperm defects is very important in order to plan the very best treatment for you. The sperm defects of head, neck and tail get listed in percentage. If there are mainly head defects even an ICSI treatment kann lead to fertilization failure if no rescue remedies in the fertiltiy lab get applied (special fertilization techniques). This is why it is so important for us to check your sperm on beforehand, it helps us to prevent unpleasant surprises during your fertilty treatment.

 Bacteria, white blood cells and immature sperm cells

A special dye technique helps us to detect bacteria, immature sperm cells and white blood cells in the ejaculate. Normally there should be no bacteria. The presence of white blood cells can indicate a genital tract infection, if the white cell count is higher than 1Mio/ ml antibiotic therapy might be adviced.

 Anti-Sperm-Antibody-Test

This test detects antibodies which affect the sperm in the ejaculate. Anti-sperm-antibodies can be found in the blood stream, vaginal discharge und in the ejaculate itself. They can be present in men and in women and show a reaction of the respective immune system towards the sperm itself.

For this test a special substance gets added, which will only bind to affected sperm. The calculation of the percentage of affected sperm gives us information if the body reacts to sperm with antibodies or not. The less sperm affected the better is the sperm quality and the probability of conception. In the case of a high anti-sperm-antibody-count the ejaculate can be prepared with a special washing technique in the lab fpr fertility treatment.

 Sperm Vitality

The percentage of vital sperm gets counted and calculated after special staining. The minimum amount of vital sperm should be 58% for a natural conception to occur.

 Sperm Size

Smaller sized sperm and bigger than average sized sperm often points towards genetic anomaly. This should be investigated further.

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