How to interpret the semenogram?

Usually, when we go to the fertility clinic, the doctor asks the man for a semen analysis. This is because in 40-50% of cases the primary diagnosis is male infertility. It is calculated that the male factor is present in 2 out of every 3 fertility problems and the semen analysis is the simplest diagnostic tool and the one that gives us a first glimpse of the existence of alterations in the fertile capacity of the spermatozoa.

The problem is when we are given the result, full of very strange words, numbers and percentages that we do not know how to interpret. For this reason, we want to give you some simple guidelines, so that you can understand the result and know if there is any alteration.

However, you should know that behind a cell, as behind any body fluid, there is a lot of information hidden and it is the andrologist who must study and pay attention to each of the aspects of these cells and fluids, which will allow him to know, not only the reproductive capacity of the spermatozoa, but also the state of the glands that make up the reproductive system and, on many occasions, the state of health of the individual.

• The semenogram is the systematic analysis of the different components that make up the ejaculate.

• It is the most important laboratory test for the study of male reproductive function.

• The result complements the medical history and physical examination.

• If the result is altered, it may lead the doctor to consider further complementary examinations.

There are 5 basic parameters to be taken into account in a semen analysis:

1. Colour: the semen should be pearly white. Any alteration in the colour may indicate the existence of a pathology, usually an infection or bleeding (haemospermia), which should be checked immediately.
   
   
2. Volume: each ejaculate should have a volume of between 1.5 and 6 mL. A lower volume (Hypospermia) can mean deficiency in the secretion of the seminal vesicles, long periods of sexual abstinence, dysfunctions of the urinary sphincter mechanism or low testosterone levels. A seminal volume greater than 6 mL (hyperspermia) may mean long periods of sexual abstinence or the existence of a varicocele (testicular varicose veins).
   
   
3. Sperm count or concentration: a concentration of 15 million/mL or more, or a sperm count of more than 39 million sperm in the whole ejaculate, is considered normal.
   
   A low sperm count is called Oligozoospermia which means that there are fewer sperm than should be expected. It may be due to recent febrile processes, chromosomal abnormalities, varicocele, endocrine problems such as exposure to endocrine disruptors or unhealthy lifestyle habits. Sometimes no spermatozoa can be observed in the ejaculate. This is known as Azoospermia, which can be obstructive or excretory (there is an alteration that is preventing the passage of sperm) or secretory, where there is a failure in sperm production.
   
   
4. Motility: Various degrees of motility are considered, however, for there to be no reproductive problems there should be at least 32% of progressive motility. Below this value, Astenozoospermia is considered to exist. The causes of low sperm motility are often related to the consumption of toxic substances and bad lifestyle habits. Smoking, alcohol consumption, drugs, stress and unsaturated fats are enemies of good sperm motility and sperm health. In men over 45 years of age, sperm motility decreases, as well as when exposed to excessive temperature and fever, chemical toxins (pesticides, fertilisers, solvents), radio and chemotherapy or genital infections.
   
   
5. Sperm morphology or altered sperm shape. A value of 4 % or more is considered normal. A lower value will receive the diagnosis of Teratozoospermia. The shape of the sperm determines how many of them will be able to attach to the zona pellucida of the oocytes and are therefore potentially fertilising. Morphological alterations are related to the presence of varicocele, testicular and seminal tract infections, situations that cause oxidative stress or inadequate lifestyle habits.

Do you need us to help you interpret the semen analysis? Do not hesitate to arrange a free initial consultation with our Andrology Service, so that we can analyse your case and decide which treatment or assisted reproduction technique will be the most appropriate in your case.