When the desire to have children remains unfulfilled, couples often find themselves in a phase filled with questions and uncertainties. A spermiogram can assist in providing initial answers and identifying potential reasons for the lack of pregnancy. In this article, you will learn what a spermiogram entails, the detailed procedure of the test, and the key values considered during the evaluation. Additionally, we will outline the steps you can take to improve the results or pursue further diagnostic measures.
What is a Spermiogram?
A spermiogram is a laboratory test designed to evaluate male fertility. Specialists examine various parameters in a semen sample, particularly:
- Sperm Count: The number of sperm present per milliliter of ejaculate.
- Motility: The activity level of the sperm.
- Morphology: The shape of the sperm and the percentage of normally shaped sperm.
- Ejaculate Volume: The total amount of fluid produced.
These values provide an initial assessment of whether a man's sperm are capable of fertilizing an egg.
When is a Spermiogram Recommended?
A spermiogram is typically recommended if no pregnancy occurs after one year of regular, unprotected intercourse. Additionally, the test is advisable in other scenarios, such as:
- Suspected hormonal imbalances or abnormal blood test results.
- Before or after sterilisation (vasectomy) to verify its success.
- In cases of recurrent miscarriages to identify possible causes.
Costs and Reimbursement
The cost of a spermiogram generally ranges between ₹4,800 and ₹7,200. With a valid medical indication, such as an unfulfilled desire to have children, statutory health insurance typically covers the expenses. Private health insurance policies may vary in their coverage, so it is advisable to inquire in advance.
Procedure of the Spermiogram
1. Preparation
To ensure the most accurate results, please adhere to the following recommendations:
- Avoid ejaculation for 3–5 days prior to sample collection.
- Refrain from consuming alcohol and nicotine in the days leading up to the test.
- Minimize stress and ensure adequate sleep.
2. Sample Collection
The sample is typically collected through masturbation in a private room within the clinic or laboratory. Ensure the following:
- Thoroughly clean your hands and penis with water and soap (do not use disinfectants).
- Do not use lubricants, as they can affect the sperm.
- Collect the entire ejaculate in a sterile container provided by the laboratory.
Alternatively, you may collect the sample at home. In such cases, ensure that the sample is kept at body temperature (e.g., in a jacket pocket) and submit it to the clinic or laboratory within a maximum of 60 minutes.
Laboratory Analysis: Key Parameters Measured
The semen analysis is performed under a microscope and involves various tests. According to the World Health Organization (WHO) guidelines, the following parameters are particularly important:
- Ejaculate Volume: At least 1.5 ml.
- Sperm Concentration: At least 15 million sperm per milliliter.
- Total Sperm Count: At least 39 million sperm per ejaculate.
- Motility: At least 40 percent of sperm are motile.
- Morphology: At least 4 percent of sperm are normally shaped.
These reference values serve as guidelines. Minor deviations should be evaluated on an individual basis and do not necessarily indicate infertility.
Duration of Analysis and Result Discussion
The actual analysis typically takes 1–2 hours. Following this, the laboratory processes the data, and the complete report is usually available within a few days. Your physician will discuss the results with you and explain whether further examinations or treatment steps are advisable.
Interpretation of Results
If there are deviations from the reference values, medical professionals generally refer to the following conditions:
- Oligozoospermia: Low sperm concentration.
- Asthenozoospermia: Reduced sperm motility.
- Teratozoospermia: High percentage of abnormally shaped sperm.
- Azoospermia: No sperm detected in the ejaculate.
It is crucial to thoroughly investigate the underlying causes in each case. These may include hormonal imbalances, genetic factors, infections, or unfavorable lifestyle habits.
Common Causes of Abnormal Results
Sperm production can be affected by a multitude of factors. For example:
- Hormonal Disorders: Imbalances in testosterone, follicle-stimulating hormone, or luteinizing hormone.
- Genetic Factors: Chromosomal anomalies or hereditary diseases.
- Infections: Such as sexually transmitted infections.
- Lifestyle Factors: Smoking, alcohol consumption, obesity, and stress.
- Environmental Factors: Exposure to pollutants, excessive heat, radiation, or chemicals.
Often, doctors recommend repeating the spermiogram to rule out potential measurement errors or short-term influences like fever or infections.
Improving Sperm Quality
Poor semen quality does not have to be a permanent condition. Many men can enhance their sperm parameters through targeted measures:
- Diet: Maintain a balanced diet rich in fruits, vegetables, whole grains, and proteins.
- Exercise & Physical Activity: Engage in moderate but regular physical activity to boost metabolism.
- Reduce Smoking & Alcohol: Toxins from smoking and excessive alcohol consumption can impair sperm production.
- Stress Management: Practices such as yoga, meditation, or autogenic training can have positive effects.
- Minimize Heat Exposure: Avoid tight underwear and frequent sauna visits, as excessive heat can damage sperm.
Additionally, medical treatments like hormone therapy or targeted infection treatments may be beneficial, depending on individual findings.
Further Diagnostics and Fertility Treatments
If the results indicate significant abnormalities, further tests may be necessary. These include:
- Hormone Analyses: Measuring levels of testosterone, follicle-stimulating hormone, luteinizing hormone, and prolactin.
- Genetic Testing: Checking for chromosomal abnormalities.
- Ultrasound: Examining the testes and epididymis.
- DNA Fragmentation Test: Assessing the genetic integrity of the sperm.
In cases of severely impaired sperm parameters, assisted reproductive technologies such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) may be considered.
What If the Spermiogram is Normal?
Even if the spermiogram results are normal, a pregnancy may still not occur. In such cases, it is important to investigate potential causes in the female partner as well, such as menstrual cycle disorders or hormonal imbalances. A joint consultation at a fertility centre can provide clarity and outline the next steps.
Conclusion
A spermiogram is an essential step in evaluating male fertility. It provides valuable insights into key parameters such as sperm count, motility, and morphology. If the results fall outside the normal range, there are numerous strategies to address the issues—from lifestyle modifications to specific medical treatments. If pregnancy remains elusive despite normal spermiogram results, a comprehensive evaluation of both partners is recommended. This approach brings you closer to fulfilling your desire to start a family.