When a married couple cannot conceive a child, many believe that the reason lies in the woman's health condition. In fact, this is not always the case. About 40% of cases are related to male infertility. That is why both spouses should be tested for the impossibility of getting pregnant.
The complex of examinations for a woman is large and laborious. Sometimes it is enough for a man to simply hand over a semen sample for a spermogram. In this material we will tell you how this analysis is carried out, what are its norms, how to decipher the result and what to do if the actual results are far from ideal.
What it is?
If we decompose the word "spermogram" into two Greek roots ("sperm" - σπέρμα and "gram" -γράμμα), then literally this medical term will mean "record of the seed." In fact, this is a laboratory study, a sperm analysis, which allows you to find out how suitable it is for fertilizing a female egg.
The analysis makes it possible to find out some quantitative and qualitative indicators of a man's sperm, which gives the doctor who conducts the diagnosis, the opportunity to assert whether family infertility is male, whether a man has diseases of the reproductive system.
The study is assigned not only to the stronger sex, whose wives cannot conceive in any way or suffer from habitual miscarriages and miscarriages, but also to men who are preparing to become sperm donors, as well as men who would like to freeze their germ cells for the future (cryopreservation is recommended for those who at a young age goes on life-threatening military missions, works at facilities with high radiation levels and is in other circumstances that can adversely affect a man's ability to have children in the future).
The first spermogram in the history of mankind was carried out by the legendary scientist Levenguk, the creator of microscopes, back in the 17th century. True, his research was superficial. He just drew attention to the fact that in a number of representatives of the stronger sex, the cells in the ejaculate move more actively than in others. It took humanity about 300 years to formulate the theses.
Only at the beginning of the 20th century were uniform requirements for the quantitative indicators of male semen created. They have been revised several times by the World Health Organization, and the last revision was made to the analysis in 2010.
All over the world, spermogram standards are beyond doubt. However, Russia has developed its own practice, which is different from the world one. So, only a part of laboratories that can test semen work according to WHO standards. The rest have their own standards and requirements, as well as assessment criteria and ideas about pathology and the norm.
Therefore, we wanted to start this article with one important wish. Before comparing your spermogram results with the WHO standards presented below, check with the laboratory where the analysis was carried out if it works to these standards. If not, then you can ask about the specific standards of this laboratory.
Specialists in reproductive medicine are confident that in the near future all laboratories in Russia will switch to world standards, but that will be later.
Why is the analysis carried out and how to take it?
A spermogram is needed in order to find out how high a man's fertile ability, that is, the ability to fertilize, is. An examination is carried out under a microscope. The diagnostician determines the quantity, quality and some other properties of the sperm.
Sometimes there is a need for additional tests, for example, the MAP test, which allows you to identify special immunological processes - the production of antibodies to sperm. Sometimes the doctor needs data on the biochemistry of the ejaculate, in order to understand the genetic value carried by sperm, a spermogram with DNA fragmentation is performed. The analysis is prepared differently in different laboratories. On average, it takes from 1 to 3 days, but it happens that the terms are delayed, for example, if genetic testing is required.
For the results to be reliable, a man should know the rules by which the analysis is done. They relate to adherence to the recommendations before delivery:
- For 3-6 days, a man should limit sexual intercourse and not masturbate. During this time, a sufficient number of germ cells will have time to mature in order to imagine their average number. It is necessary to abstain for the specified number of days before donating sperm, since prolonged abstinence also negatively affects the composition of the ejaculate, after prolonged abstinence the sperm is thick, viscous, this complicates the study.
- A week before delivery, a man should refrain from sunbathing and visiting a solarium, from going to the bathhouse, sauna and any heat effects on the genitals. The seat heaters in the car should also not be turned on.
- A week before delivery, you should not take alcoholic beverages and even more so drugs, smoke a lot. It is advisable to refuse taking medications, but if this is not possible, it is better to postpone the analysis to another time. The effects of antibiotics, hormones, and other drugs on sperm quality can be devastating.
- Usually the analysis is done by masturbation. This can be done both in a clinic and at home, where it is psychologically easier and more familiar for a man. In the clinic, a special container for biomaterials is issued to collect ejaculate. For home collection, such a container or medical condom without lubrication and foreign substances can also be issued, in which a man can have a normal full sexual intercourse with his partner. Fertility doctors consider the most preferred method in which a man takes tests in a clinic in a special jar.
- It is important to deliver the ejaculate collected by any of the methods to the laboratory as soon as possible - it is advisable to do this within 1 hour. When transporting, it is important to remember that the seed should be at a temperature close to body temperature. To do this, you can use a special thermal container. It can be bought at a pharmacy or obtained from a clinic with which an examination contract has been concluded.
It is impossible to check the quality of sperm at home. But you can suspect pathology by conducting a home test SpermCheck... The test and instructions for it can be purchased at the pharmacy, the conduct is not much more difficult than a regular pregnancy test. However, the test system determines (not too accurately, by the way) only the number of sperm in the ejaculate (approximately).
Male infertility, on the other hand, can be associated not only with quantitative disorders, but also with qualitative ones (there are abnormalities in the structure of germ cells, there are deviations in functionality), and therefore there are no alternatives to spermogram.
What does it show?
A spermogram gives an idea of the microscopic and macroscopic features of the sex cells of a given man. All parameters that are evaluated in a laboratory according to WHO standards are presented below.
Quantity, volume
This indicator is very important not so much for determining the level of fertility as for the correct implementation of all laboratory manipulations with the ejaculate. It is measured with a special graduated wall pipette. It also determines the viscosity of the sperm.
For a normal study, at least 1.5-2 ml of semen is needed. The volume depends on the amount of specific fluid produced by the seminal vesicles and the prostate gland.
Lack of fluid can indicate problems with these areas of the male reproductive system. The shorter the period of abstinence, the less sperm is released.
Liquefaction time
Sperm tend to liquefy, become more fluid as a certain time passes from the moment of ejaculation. This time is called the liquefaction time. It is different for all men, fluctuations are significant - from 15 minutes to an hour. Sometimes, with certain pathologies, the sperm cannot be diluted at all.
The viscosity is determined by the length of the "string" that remains when the laboratory glass rod touches the semen when the instrument is lifted. If it is more than 2 centimeters, the semen is considered viscous.
A special protein ensures immobility and inactivity of sperm cells while they are in the male gonads. Under the influence of the juice of the prostate gland, the protein dissolves, the "gums" become active and mobile.
If liquefaction does not occur, the doctor will suspect the pathology of the prostate gland. Some enzymes, which are added artificially, in order to evaluate other parameters, help to dilute sperm in the laboratory.
Acidity level
This indicator is determined by special indicators made of paper or a special device: the pH of a healthy man is above 7.2. Insufficient acidity reduces the ability of sperm to dissolve the egg membrane upon implantation, thus reducing fertility.
Smell and color
You cannot judge infertility by smell. This parameter does not have any particular diagnostic value at all, however, it continues to be indicated in the conclusion about the spermogram performed, which raises a lot of questions from the spouses and gives rise to many myths about the relationship between smell and the fertile ability of a man. There is no connection.
They point out that the smell is "specific" only by tradition, by habit, because it has always been so. You shouldn't pay special attention to this parameter.
Sperm color is considered the same questionable parameter. It is believed that in a healthy man it should be white or grayish. Pink, yellowish, greenish shades can indicate pathologies - impurities of blood, pus. However, the spermogram quite accurately answers the question of the presence and absence of substances at the cellular level, so there is no need to evaluate the color separately. It is indicated, like the smell, more as a tribute to medical traditions.
In fairness, it should be noted that the smell of semen is given by a special enzyme - sperm. Its functions are still unknown to medicine and science. But some doctors argue that the smell can be judged on the health of the prostate gland, which produces this very sperm. There is no official evidence for this method of diagnosing prostate problems.
Sperm count
Laboratory technicians calculate the number of germ cells in 1 ml of liquid, as well as in the entire volume of the ejaculate completely. You should not think that a person considers "lively" ones. This would be impossible, because there are millions of them in 1 ml. Calculations are performed by special counting chambers.
To speed up the math process, a technician can apply semen onto a 22x22 glass. In a drop of sperm on such a glass with a microscope magnification of 400, the number of cells appears in the field of view, which will indicate the number of cells in 1 milliliter. For example, a laboratory assistant sees 20 cells, this will mean there are 20 million cells in 1 ml.
In some laboratories there are sperm analyzers - special microscopes with a built-in camera, which themselves record and count the number of germ cells in the semen. In the event that there are few spermatozoa, and it is possible to see only single caudate representatives in the field of view of the microscope, the sperm is placed in a centrifuge and the number of cells in the sediment is examined.
General cell motility
According to their ability to move and ultimately achieve the cherished goal of the eggs, all sperm are divided into 4 groups, designated by capital Latin letters from A to D.
The most stubborn and purposeful cells are category A. Doctors describe them as progressive, active-mobile. Such sex cells move only straight and fast enough, at a speed of 25 micrometers per second. That is, in two seconds, such selected "zips" have time to overcome the distance, which is equal to their own height.
Sperm of category B differ from their elite comrades only in speed, it is slightly lower. But they also have a direction of movement - only straight ahead and not a micrometer to the sides. It is believed that only sperm with mobility categories A and B are able to fertilize a female reproductive cell.
Category C cells can behave in different ways. Either move in one place, or move chaotically, not in a forward direction, in circles, zigzags, etc. They are called non-progressive-mobile, and such sperm do not cause special hopes for fertilization.
The "livestock" of the last category D don't move at all.
For conception, it is important that the future dad's sperm contain at least a quarter of the germ cells of category A. If this number is less, then the laboratory assistant assesses them in total with category B “colleagues”.
A healthy spermogram will be considered a result in which at least 50% of category A and B "zips" are found in the man's sperm in total.
The ability of germ cells to move is also monitored by sperm analyzers or counting chambers. This happens simultaneously with the calculation of their number.
Sperm morphology
This is an expanded study of the structure of the sperm. Microscopically, the doctor examines how the sex cells of a man are folded. The shape and structure of the head, neck, middle part, tail, and the appearance of sperm are evaluated.
Most often, the strict Kruger criteria are used, according to which the structural features of cells are compared with the standard, and any borderline value belongs to the category of pathology, the cell is rejected.
The sperm head should be in the singular, even and oval. It should not be squeezed or tapered. The dimensions of the head are 4-5.5 microns in length, 2.5-3.5 microns in width.
Particular attention is paid to the acrosome in the head structure. It should not have vacuoles, it should occupy about half of the head area.
The sperm neck should be flat, small, no more than 1 micron. It is important that it is tightly and securely connected to the head, eliminating the possibility of the tail coming off. The connection must be at right angles.
The tail or flagellum is the longest part of the male reproductive cell. She must borrow not less than 90% of the total sperm length... The tail should be one, even, slightly tapering towards the end. Twisted tails, short or broken flagella, like the pathology of the head, the middle part of the cell, are the basis for culling.
Do not think that a healthy man does not have defective sperm. There are always a lot of them. WHO at various times recommended to regard the presence of pathological morphologically cells as the norm in the range from 50 to 70%.
The Kruger criteria unequivocally state that the proportion of sperm with defects can be up to 85%. Thus, for conception in a natural way, it is necessary for a man to have at least 14-15% of reference, ideal, perfectly healthy and morphologically correct spermatozoa.
Viability
This parameter indicates the number of living sex cells in the ejaculate.If the sperm is mobile, then it is definitely alive. But an immobile cell can be either alive or dead.
It is considered normal if a man's sperm contains at least half of the living cells of different categories of mobility (A, B and C). Category D cells are immobile, but their vital activity should be investigated only if the remaining living cells are less than 50%.
To understand whether the "live" is alive, assess the state of its outer membrane. After cell death, the integrity of this membrane is violated. The eosin dye is added to the sample. It cannot get inside a living sperm with a whole membrane, but it easily penetrates into dead cells, the membrane of which is already broken. These sperm cells turn pink under the influence of the dye.
Another method involves placing a semen sample in a hypotonic solution. At the same time, living and healthy cells begin to increase, swell, their tails begin to twist into loops, and the dead do not react in any way. With both methods, the result is assessed using a microscope.
Rounded cells
In addition to the tailed sperm, the semen of a man contains other cells that are not sex at all. They are called rounded or round. This mainly includes two types of cells - leukocytes and immature spermatogenesis cells.
At first, the World Health Organization proposed to determine their concentration, believing that this could indicate, for example, an increase in leukocytes in semen. Later, the organization itself canceled its instruction, recognizing that the concentration of round cells is not of great diagnostic value. Some laboratories continue, out of habit, to fill out this column of the spermogram form, but you should not pay attention to it.
Immature cells, which have yet to become sperm, are also found in absolutely any man. Their number may vary, it is not constant, and the total concentration of such round cells is also considered uninformative. If it is determined, it is exclusively "out of habit."
Leukocytes
Everyone has leukocytes in semen. The important thing is how large their number is. If more than 1 million of such cells are found in 1 milliliter of semen, then, with a high degree of probability, the man has inflammatory processes in the area of the prostate gland or seminal vesicles.
To identify leukocytes, a sperm staining method is used and its subsequent study under a microscope. This is the only way to distinguish leukocytes from cells that will soon become spermatozoa, but for now are embryonic round cells.
Antisperm antibodies
A man's body, like a woman's body, can produce antibodies to sperm, and this will significantly complicate the task of conceiving a child, because immunity will simply destroy male germ cells with special antibodies, considering sperm as a threat. Such immunity can develop with infections of the genital tract, with anal sex.
If antibodies attack the head of the sperm, then the germ cell will not be able to fuse with the egg. If the tail of the sperm is attacked, the cell will lose its ability to move.
The presence of such destructive antibodies can be indicated by spermagglutination - the adhesion of spermatozoa to each other by the affected part - the heads or tails.
To detect the presence of antibodies accurately allows MAP test, during which a preparation is added to the semen sample, which is a rabbit antibodies against human antibodies. If the drug, or rather the silicone microparticles that are included in it, adhere to the sperm, with a high degree of probability we are talking about immunological infertility.
Normal results - transcript
Good indicators of a healthy semen analysis are as follows:
Pathologies can be varied, all of them in one way or another are associated with quantitative and qualitative deviations from the norms, as well as dysfunctions of male sex cells. Pathological conditions - description and causes
If no pathological forms are found in the spermogram, then the doctor uses the term "Normozoosperia", which means that the check did not reveal pathologies and the semen indicators are normal.
If pathological forms are found, then there may be a lot of names for that. Let's tell you more about them.
Oligozoospermia
This term refers to a pathological condition in which the number of sperm in the ejaculate is significantly less than the existing standard values.
The concentration of germ cells can be influenced by both congenital and acquired causes. This can be either a complete congenital absence of the testicles, or the presence, but not descending them into the scrotum (cryptorchidism). Often the number of germ cells decreases due to the expansion of the veins of the spermatic cord - varicocele.
Sperm count may be reduced due to trauma or inflammation of the testicles, due to a chronic sexually transmitted infection (mycoplasma, ureaplasma, chlamydia, etc.).
If a man regularly overheats the scrotum, for example, is a big fan of visiting a sauna or taking a steam bath, working in conditions of high temperatures, then the number of germ cells in the seminal fluid may also be reduced.
The root of the problem may lie in the pathologies of the spinal cord, kidneys and liver, uncontrolled heavy smoking, drug use. The influence of alcohol on sperm count is also great, and if a man abuses intoxicating drinks, then oligozoospermia is just one of several diagnoses that can be expected from a spermogram.
A decrease in sperm count can be observed with inadequate, insufficient, irregular nutrition, with frequent stress and heavy physical exertion, insufficient sleep, as well as with hormonal disorders, for example, with insufficient testosterone levels, and with frequent intercourse. It is for this reason that a man is advised to abstain from sex and masturbation before donating sperm for a test.
Asthenozoospermia
This is how doctors call a condition in which sperm motility is impaired. There may be enough of them, but conception does not occur, since the germ cells are simply do not get to the egg due to reduced activity.
The reason for the lazy behavior of "lively" can be a violation of the morphology of the germ cells themselves, with some anomalies the sperm have no tails, or, conversely, there are two or more flagella, the head is reduced or enlarged.
Abnormalities in the development of sperm cells can be congenital or acquired, which became possible due to poor ecology, due to the wrong lifestyle of a man.
The reason for the inability of sperm to actively move forward (dyskinesia) may be the high viscosity of the semen. Increased viscosity is often observed in men who are sexually active too rarely, as well as in men whose activities are associated with exposure to toxic substances and poisons. Violation of the ability of germ cells to move can be observed with advanced forms of genital infections, as well as with prostatitis.
Teratozoospermia
This term denotes the presence in the semen of a large number of ugly, mutated spermatozoa, with morphological disorders - pathologies of the head, tail, middle part, neck. They can be more than just a reason for the inability to get pregnant, but also the cause of miscarriages in women, the cause of gross chromosomal abnormalities in the fetus.
That is why it is important to assess the morphology of a man's germ cells before pregnancy, so as not to state sad facts while carrying a child or after terminating a pregnancy.
The causes of abnormalities in the structure of germ cells in the stronger sex may be hormones. If a man has a hormonal failure, the number of reference, ideal for conception of germ cells in the ejaculate is significantly reduced.
Quite often, sperm morphology is disturbed in men who undergo hormonal treatment or use steroid hormones for sports, fitness, bodybuilding, and weightlifting.
Sex cells can mutate with viral infections. The most dangerous of these diseases is considered to be herpes infection of the second type, which is also called genital herpes.
Excessive consumption of beer and other alcoholic beverages, nicotine, drugs, stress and lack of sleep, unhealthy diet, and lack of vitamins also have an important effect. Living in regions with unfavorable ecology or simply conditions of a gas-polluted big city is also a prerequisite for disrupting the morphology of sperm.
Azoospermia
Behind this name lies a severe form of male infertility, in which there are no sperm in the ejaculate at all. If the pathology is of an obstructive cause, then the sperm cannot mechanically come out and mix with the seminal fluid, for example, due to pathologies in the structure of the reproductive system.
Blockages can occur in the epididymis or in the seminal ducts. Non-obstructive reasons for the absence of germ cells in semen are associated with abnormalities in sperm production initially.
Azoospermia can occur as a result of severe inflammatory diseases of the reproductive system, both viral and bacterial in origin. The disease can be inherited if the corresponding gene "plays" in the genetic set. For example, the complete absence of the vas deferens may be congenital.
The reason for the absence of sperm may lie in the trauma of the testicles, in the operations carried out on the spinal cord or liver.
Operation vasectomy, in which the ducts are crossed or pulled, leads to complete sterility of the sperm, to the absence of sperm in the fluid, which is used as a means of surgical contraception.
Lack of "live" due to violations of their production occurs often under the influence of antibiotics, drugs for the treatment of cancer, after undergoing chemotherapy and radiation therapy for cancer.
Aspermia
This is a complete absence of sperm during orgasm or a very small amount of it. With true aspermia, sperm is not released at all, and there are no bright orgasmic sensations at the end of intercourse. With false aspermia, men experience an orgasm, there may even be a small amount of ejaculate, but there is not a single sperm in it.
Retrograde ejaculation, when semen is ejected into the bladder, can cause this phenomenon. Often the prerequisites for the development of aspermia are created for a long time by untreated venereal diseases, inflammatory processes in the organs of the reproductive system of the stronger sex.
Not the least among the reasons for the absence of sperm is given to mental and emotional disorders, injuries of the spine and brain, as well as congenital defects of the testicles and vas deferens.
Aspermia can be a complication of such a common disease as diabetes, tuberculosis. It is often diagnosed in men who abuse alcohol and drugs. In old age, men experience physiological aspermia, which is considered irreversible. In all other cases medicine is ready to help a man still become a father, but specific actions depend on the root cause of the condition.
Leukocytospermia
An excess of leukocyte levels in semen is diagnosed as a fait accompli. It is not always possible to establish the true cause of the abundance of white blood cells in the ejaculate. A large number of leukocytes destroys the membranes of the sperm and reduces their ability to move.
The appearance of these cells in sperm always indicates an inflammatory process. But the place of localization of the process is not always found, especially if the disease is chronic and is almost asymptomatic.
Often, excess white blood cells in excess of the standards presented in the table above appear in semen due to vesiculitis, prostatitis, urethritis and other inflammatory ailments. Therefore, with such a spermogram result, an additional examination, quite impressive in scale, will be required, including tests for infections, urine culture and other diagnostic methods.
Akinospermia
With this pathology, there is a complete immobility of the sperm. They can be alive, contain normal genetic material, but they cannot reach their goal, the ovum. The sex cells of a man can be immobile from birth, that is, his spermatozoa are already formed with impaired motor function, or they can become immobile under the influence of acquired factors.
The reason for the production of such germ cells can be damage to the epithelium, which was accompanied by an infectious or inflammatory disease of the genitourinary system, including a venereal disease.
Sperm can become immobile with ankylosing spondylitis or rheumatoid arthritis. Cell mobility can be completely lost due to significant excess of the level of antisperm antibodies.
Necrospermia
With this pathology in the sperm completely or almost completely no live sperm... If the problem is true, and sperm cells are already being produced unviable, then medicine, alas, will not be able to help.
However, this form of necrospermia is extremely rare. Most often, representatives of the stronger sex have partial or complete necrospermia, in which the death of germ cells occurs under the influence of some negative factors after production.
In the first place in terms of the murderous effect on sperm are genital infections transmitted intimate way. Further, there are hormonal disruptions in which the level of male hormones in a man's body is insufficient to support the life of germ cells.
Also, dead sperm can become with tuberculosis, renal failure, after injuries of the reproductive organs or radiation exposure. Varicocele may become a prerequisite for the development of pathology.
Bacteria and viruses cause a decrease in the acidity of sperm, as a result of which sperm, which are very sensitive to changes in their environment, begin to die en masse in a matter of hours.
Spermatozoa are not renewed as often, the spermatogenesis cycle takes 74 days. However, in the case of complete and partial necrospermia, doctors can help a man become a father.
Cryptospermia
Such a diagnosis is made after a spermogram with traditional methods revealed such a small amount of sperm that centrifugation had to be done. Cryptospermia is a negligible number of germ cells in the sediment after passing through a centrifuge.
The cause of the phenomenon can be a mumps transferred in childhood (infectious mumps), as well as varicocele, genetic pathologies of the genital organs and reproductive system, hormonal imbalance. All causes, except genetic and congenital, respond well to medical correction.
Hemospermia
They talk about such a pathology if blood is found in the spermogram. Normally, there should be no blood in the ejaculate. True hemospermia differs from false in that blood enters the seminal fluid from the testicles, the prostate gland.And with a false type of pathology, it in the form of veins is mixed into the ejaculate already in the urethra when passing out.
The cause may be prostatitis, urethritis, vesiculitis. Also, blood in the semen can be observed in some cancers. This pathology, unlike many other problems with sperm, has symptoms, and a man will be able to notice them in time. This is not only a visual change in the color of semen, but also pain during urination, a decrease in libido, a decrease in orgasmic sensations.
The reason may also lie in frequent and intense sexual intercourse, inflammatory processes, impaired blood supply to the male reproductive system.
Treatment and recommendations for improving sperm quality
It is possible to speak about the restoration of sperm quality only after the causes of pathological forms of spermogram have been identified. The treatment usually works well, and 90% of men with acquired pathologies manage to restore fertility.
If the reason lies in infections, and this is proved by laboratory tests (blood, smears, urine), then antibiotic treatment is prescribed, in case of herpes infection - antiherpetic drugs. An antibiotic is often prescribed "Levofloxacin", related to drugs of a wide spectrum of action.
After anti-inflammatory treatment, a man is recommended a course of vitamins during the spermatogenesis cycle - about 3 months. This time is needed to restore the quality and quantity of sperm.
For men, whose causes of infertility lie in mechanical barriers to sperm discharge, surgical treatment can be performed, followed by a course of antibiotics to prevent the inflammatory process. Vitamins E, A, C, D, B, folic acid, minerals, especially zinc and selenium preparations, shown to all men with violations of the quantity and quality of semen.
If the reason is non-infectious, then sometimes it is enough to change the situation - to live for several months not in urban conditions, but outside the city, in the fresh air.
Correction of nutrition includes the introduction of protein products, milk, meat, fish, cottage cheese into the diet. In order to increase the volume and functionality of ejaculate, a man needs to follow a drinking regimen, give up bad habits and follow a doctor-recommended regimen of sexual activity (too frequent sex harms sperm quality no less than too rare sexual relations).
An increase in the quality of sperm often occurs after a man corrects his work activity, refuses to work on the night shift, starts getting enough sleep, and fully rests.
Weekend on the couch should be replaced by skiing or swimming, cycling, light jogging.
If the cause of the pathological form of the spermogram lies in a hormonal failure or imbalance, an endocrinologist prescribes treatment with hormonal corrective agents. Simultaneously with such therapy, the necessary vitamin complexes for men are taken.
If the treatment does not help improve the performance, then such reproductive assistive methods as IVF and ICSI.
In an extreme case (and such a need arises only in the case of a genetic pathology in a man, an irreparable, total pathology of spermatogenesis), donor sperm may be required for fertilization. There would be a desire to have children, but modern medicine will tell you the way.
Reviews
Men are rather reluctant to leave reviews about the passage of such diagnostics on the Internet, but among them you can still find really informative ones. Firstly, most of those who have already decided on a spermogram come to a discovery that is stunning in its simplicity - it is not scary, not disgusting and not at all ashamed. There is absolutely nothing to be ashamed of in this diagnosis.
Secondly, the results are exhaustive, and on their basis it becomes clear in which direction the couple should move on - to start treatment or to additionally check the health status of the female half of the family.
The analysis is not expensive, it can be done in any city, since many clinics provide such a service.
For information on how to take a spermogram correctly, see the next video.
