Semen Analysis (Spermiogram)

What Is a Spermiogram?

A spermiogram is a test that can be used to examine a man's fertility (ability to have children). For example, if a couple cannot have children, the cause of this can be sought in the man. In addition, a spermiogram can be used to check whether a vasectomy has been performed successfully.

How Much Does the Sperm Test Cost?

A sperm test usually costs between 60 and 90 euros. The health insurance companies do not always cover the costs. In the case of an unfulfilled desire to have children over a more extended period and clarify the causes, the cost coverage should not be a problem. It is best to discuss the issue with your specialist.

How Does a Semen Analysis Work?

The semen sample is obtained from the patient by masturbation. A sterile vessel should be used and then filled in a separate room in the practice or clinic. The physician provides the vessel. Immediately afterward, the vessel with the semen sample is left to stand at 37 degrees or room temperature. In this process, the liquid of the ejaculate liquefies due to the ingredients. However, the sample must not be left to stand for too long; otherwise, the motility of the sperm decreases, and the number of dead sperm increases. This could falsify the sample.

Therefore, the analysis should be performed no later than 30 to 60 minutes after collection. To diagnose, at least two ejaculate analyses are completed within six weeks to 3 months because a spermatogenesis cycle (time until completely new sperm has been formed once) takes about ten weeks. The doctor performs the analysis with the help of a microscope (a light microscope with 400x magnification).

For accurate counting of sperm, special devices count the correctly diluted ejaculate for sperm (Neubauer-improved chamber). The first examination under the microscope is the examination of sperm motility (motility). Then, when examining the shape of the sperm, various staining techniques are used to stain different components of the sperm. Thereby, the examination of morphology serves to find potentially fertile spermatozoa. The examination is always performed in two samples (double determination), and at least 400 sperm should always be counted and evaluated.

What Is Tested During the Sperm Analysis?

During the sperm analysis, the following parameters of the sperm are examined and evaluated:

• Consistency
• Color
• Odor
• pH value
• Volume
• Sperm concentration per milliliter
• Sperm density per ejaculation
• Sperm morphology (shape of sperm)
• Sperm motility (motility of sperm)
• Sperm vitality and leukocyte concentration (number of immune cells in the sperm)

In addition, other substances are examined which, if deviated from the average values, provide information about a restriction of epididymal passage (alpha-glucosidase), indicating seminal vesicle dysfunction (fructose) or detect a restriction of prostate secretion (zinc).

The lower reference limits of the various values are based on worldwide surveys and studies of fertile men who have initiated a pregnancy with their partner within 12 months. The values indicate, on average, the minimum fertility required by a man's sperm to impregnate a woman within one year.

Furthermore, the ejaculate can be tested for sperm autoantibodies (MAR test). This is mainly done when there is a fearfulness disorder despite average sperm count and motility. Sperm autoantibodies are formed because the body recognizes the sperm as foreign and wants to destroy them.

Where Can a Sperm Examination Be Carried Out?

A spermiogram is usually carried out by a urology specialist. However, a sperm examination can also be carried out by a reproductive medicine specialist to clarify the man's fertility.

Sources:

Hautmann, Gschwend; Springer-Verlag: Urologie