At the stage of pregnancy planning, it is sometimes necessary to examine the male germ cells. Unfortunately, in recent years, the number of representatives of the stronger sex, suffering from various forms of male infertility, is growing. Environmental factors, working conditions, bad habits, nutrition affect.
What awaits a man if he was assigned not just a spermogram, but a spermogram with morphology, we will tell in this article. We will also touch on the issues of norms and deviations from them and find out how a man can improve his performance.
What it is?
Men do not like to admit that the cause of family infertility may lie in them. However, the statistics are cruel - about 40% of infertile couples who have been unsuccessfully trying to get pregnant for 3 or more years are dealing with male infertility.
Therefore, when contacting a doctor with complaints that the child “does not work out,” a complete and detailed examination is recommended not only for the woman, but also for her partner.
The main diagnostic method for the stronger sex is a spermogram. During this study the number of male germ cells, their ability to move, structural features are assessed and other parameters important for successful fertilization.
Morphological examination of sperm is one of the important components of a complete diagnosis. Without it, the picture of the processes in the spermogram will be inaccurate and incomplete.
Sperm morphology is carried out microscopically. With the help of modern high-precision equipment, the doctor divides all living and theoretically fertile sperm into normal and pathological. There are several methods for assessing the morphological features of "live". The most common is research on the so-called "Strict Kruger Criteria".
According to Kruger, sperm are strictly screened for suitability. For conception, as you know, only one healthy and normal sperm is needed, which can penetrate into the egg. But if there are more such healthy cells, then the chances of conceiving a child increase.
The Kruger scoring system involves the selection of cells according to the following parameters:
- head width and shape;
- the width of the sperm neck;
- shape and length of the tail;
- the ratio of the tail, middle part and head;
- the state of the cytoplasmic membrane of the germ cell;
- other structural features.
The conclusion always indicates the value of the Kruger fertility index. It is expressed as a percentage, and deciphering is not difficult even for people who are far from medicine.
If it is stated that the Kruger fertility index is 22%, this means that 22% of spermatozoa ideal from a morphological point of view were found in the semen sample submitted for analysis. It was they who passed a rigorous selection, withstood comparison with existing standards and are ready for fertilization.
Not always, only one spermogram with morphology is enough to establish the true causes of male infertility. Research indicators may be normal, and conception may still not be achieved.
To make the picture more complete, a man may be advised to additionally do the so-called mar-test.
This is an immunological study that will show whether these morphologically ideal sperm are exposed to antibodies.
There are other analyzes:
- The EMIS test allows one to judge the functional abilities of male germ cells;
- sperm biochemistry determines the errors in the metabolism of men and makes it possible to correct it;
- DNA fragmentation allows sperm to be evaluated from a genetic point of view.
How analysis is given, preparation
A man should carefully prepare for the examination. Doctors do not recommend having sex and masturbation for 3-6 days before the delivery of the ejaculate. So the concentration of sperm will be the most informative for laboratory research.
A week before the test, a man should refrain from taking alcohol, antibiotics, hormonal drugs.
During this preparatory week do not take a steam bath, relax in a sauna and sunbathe in the sun or in a solarium... Any heat effect on the testicles can give unreliable results, since the number of normal and motile sperm decreases when heated.
A representative of the stronger sex can donate sperm for analysis in two ways:
- Come to a medical institution and, by masturbating in a separate room, collect the material in a sterile cup.
- Collect the material at home and deliver it to the laboratory. The home method can also be carried out by masturbation; this is the priority method.
You can ask the medical facility for a special non-lubricated condom. In it, a man can have a full sexual intercourse. The semen collected in the condom should also be taken to the laboratory.
It is desirable to transport the material in compliance with the temperature regime, which is closest to the temperature of the human body. To do this, you can purchase special medical thermo container... Some clinics provide such containers to their clients free of charge.
The sperm should be in the laboratory as soon as possible - within an hour.
Normal indices of sperm morphology
Generally, a man is considered capable of conceiving naturally, without the intervention of reproductive assistive methods, in the event that:
- about 20-40 million sex cells are found in his spermogram;
- the total volume of semen is at least 2 milliliters;
- spermatozoa that are mobile and active, in this amount at least 25%;
- if the number of spermatozoa that do not "rush", but move directly to the target, in a straight trajectory, is not less than 50%.
It is considered a good sign if the spermogram shows not less than 15% of healthy, morphologically correct sperm.
The morphological assessment itself provides for an analysis of the structure of germ cells. The strict Kruger criteria even assess the borderline parameters, which many other methods refer to as normal variants, to pathology. Even the slightest inconsistency of the sperm with the standard leads to the immediate culling of this cell.
The ideal sperm cell must meet several important criteria. Here they are:
- Head... A sperm with normal head morphology always has one head, not two or more. The shape of the head is strictly oval. At least half of the head area should be occupied by an acrosome - a small space, an organoid. The normal width of the head is 2.5-3.5 microns, the normal length is considered to be in the range of 4-5.5 microns.
- Neck... This part of the male reproductive cell should not exceed 1 micron in width. The length of the neck should ideally be equal to a value not exceeding one and a half the length of the head. The neck should be connected to the head at a ninety-degree angle, correctly, without visible distortions. The neck itself should be flat.
- Tail. This part of the reproductive cell should occupy 90% of the total sperm size. The tail should be straight, not bent, not twisted, not having tubercles, knots. It tapers slightly and tapers at the end. In relation to the head, the tail should be 9-10 times larger. There is only one tail in a healthy reference sperm, not two or three.
Deviations from the norm and causes
Spermatozoa with pathological morphology look something like this:
- Head defects. Anomalies can be manifested by a change in shape from oval to round, resembling a figure eight, flattened, pear-shaped. The acrosomal area can be reduced, filled with vacuoles. Head sizes that are too large compared to the norm and significantly reduced are also considered signs of inadequacy and inadequacy. Two or more heads in one cell - a mutation that excludes the sperm from the number of healthy cells.
- Neck defects... Sperm with an abnormal neck initially appear abnormal. It is the defects in this part of the cell that greatly distort its appearance. The neck can be twisted, thickened, heterogeneous, over-thinned. It can be attached to the head not at a right angle, but dull or sharp sweat, which creates the visual effect of "skewed" sperm.
- Ponytail anomalies. Usually, among the cells with poor morphology, there are spermatozoa without a tail, with a short or too long tail, with a tail that is partially broken. If the tail part of the reproductive cell is not at right angles to the head, if the tail curls, bends in any direction, the sperm cannot be considered normal.
- Other defects. In a semen sample, lab technicians can only detect tails. This becomes possible with a loose connection of the head and neck. In this case, the germ cells are attacked by Sertoli phagocytes, and the heads cannot withstand this. Only the tails remain. Analysis with poor morphology, when the number of healthy sperm is less than 14-15%, is the basis for establishing teratozoospermia.
The chances of natural conception in such men are reduced exactly as much as the number of pathological cells is increased. In addition, there is a possibility of conceiving a child with gross chromosomal abnormalities.
The critical level of decline in healthy cells that meet the Kruger criteria is considered to be 4%. In this state of affairs, it will be difficult to fertilize an egg, even in a test tube with IVF. But modern medicine does not stand still, and even men whose fertility rate according to Kruger is at the level of 2-3% are not deprived of the opportunity to become dads.
For this they can be offered ICSI method, in which even in the pathological sperm of an infertile man, the doctor will be able to find a single healthy and corresponding to the standards sperm, inject it directly into the egg and then inject the fertilized egg into the woman.
Among the most common causes of teratozoospermia are:
- Taking hormones. Most often, this cause occurs in athletes taking steroid hormones to regulate body weight. Sometimes sperm becomes morphologically unsuitable for conception due to the fact that the man received long-term hormonal treatment.
- Hormonal imbalance. Due to various diseases, including metabolic pathologies, the ratio of hormones, including sex hormones, can change in a man's body.
- Viral infections. The morphology of sperm can be influenced by both the influenza virus and ARVI (due to high temperature), but the most serious malformations of germ cells are caused by the herpes virus of the second type, the so-called genital herpes.
- Inflammation of the genitals. Any inflammatory disease of the male reproductive organs, including such widespread prostatitis, can cause changes in the morphology of sperm.
- Lifestyle. If a man abuses alcohol, drugs, smokes a lot, improperly or does not eat enough, the risk of developing teratozoospermia increases.
- Working conditions and other factors. If the activity of a representative of the stronger sex is associated with exposure to radioactive radiation, high temperatures, then mutations in spermatozoa can be explained by these factors. The region of residence also plays a role - in territories with an unfavorable environmental situation, facts of male infertility are much more common.
- Prolonged stress. This is also one of the most common causes of abnormal sperm morphology. In the 21st century, it sometimes comes out on top.
Ways to Improve Sperm Quality
To increase the fertility of a man, it is imperative to find the true reason why his spermatozoa began to acquire pathological morphology. If it is inflammation, then treatment begins with anti-inflammatory drugs. If the cause is the herpes virus, then the treatment will be based on antiherpetic drugs.
For men who have developed teratozoospermia against a background of prolonged severe nervous stress, a psychotherapist will help restore reproductive abilities.
Those whose blood tests show hormonal disruptions will be prescribed treatment by an endocrinologist, who will proceed from the type of imbalance and the actual amount of certain hormones.
Regardless of the reason, all men are recommended to take vitamin complexes, folic acid, zinc and selenium preparations, vitamins A, E, B, D, C.
To cure teratozoospermia will help and giving up bad habits, limiting alcohol and nicotine.
Men with impaired sperm morphology are recommended to change their environment - to live outside the city for several months, away from gas pollution and other unfavorable factors. Sometimes only this measure can significantly improve the results of the analysis and increase the family's chances of conceiving a long-awaited baby.
To improve the quality of germ cells, one should take a responsible approach to the organization of nutrition, to physical activity, adjust the work and rest regime, avoiding "distortions" in it, if possible, it is worth refusing to work at night, as well as from labor "feats" overtime.
A man should definitely get enough sleep, taking at least 8-9 hours a day to sleep. It makes sense to do sports like swimming, running, skiing. Any physical activity in the fresh air will only benefit.
For information on how to improve sperm counts, see the next video.
