WHAT DO WE LEARN FROM SEMEN ANALYSIS? WHAT ARE THE NORMAL VALUES?
Semen analysis provides information about the fertilizing ability of a semen sample. It answers many questions, such as: how many spermatozoa a sample has, how fast they can move and the way they look. According to the World Health Organization (WHO, 2010) or WHO 2021 a semen sample has a good chance of fertilizing an oocyte through sexual intercourse when:
i) there are more than 15 million spermatozoa per ml and more than 39 million in the ejaculate
ii) more than 32% of the spermatozoa have progressive motility, so that they can reach the oocyte.
iii) there are enough spermatozoa with normal morphology. According to WHO, 2010, a semen sample is normal when > 4% of spermatozoa have a normal morphology.
It is important to note that semen analysis cannot determine when or whether a man will become a father. It gives, however, useful information that will help the couple decide which should the correct next step be.
WHY IS IT NECESSARY TO HAVE TWO SEMEN ANALYSIS?
The same man does not always produce a semen sample of the same quality. Without fever or use of medication that affect fertility, a man’s semen sample will vary, that is, the parameters of the semen sample will differ from one ejaculation to another. As shown in the World Health Organization (WHO, 2010) diagram on the number of spermatozoa counted in different samples of the same man, these changes can be very large.
WHY DO SEMEN ANALYSIS FROM DIFFERENT LABORATORIES VARY GREATLY?
Many times when the semen analysis is performed in different laboratories the results vary a lot and the doctor cannot reach a definite conclusion. An important reason is, as mentioned above, the variation observed in sperm samples between different ejaculations of the same man. However, the main reason is the fact that all parameters of semen analysis are based on subjective evaluations. That means that this test should be performed only by laboratories that specialize in the diagnosis of male infertility. It is therefore of the upmost importance the participation of the lab to Quality Control Programs because this ensures the quality of the laboratory result. On top of that it is necessary for the operation and organization of the laboratory to be certified by international standards of quality management systems, such as the well-known ISO 9001, or quality management systems that are designed specifically for health laboratories, such as the EN 15224:2017.
WHICH LABORATORY SHOULD I CHOOSE FOR A RELIABLE SEMEN ANALYSIS?
Semen analysis must be performed by specialized laboratories that must have:
i)the right equipment. Special microscopes and pipettes and specialized instruments are required to perform functional tests.
ii) trained personnel. All measurements are subjective and this is the reason why the correct training and experience of the scientist performing the analysis is of the outmost importance.
iii) routine operation of quality control systems. Zeginiadou-Andrology laboratory has – from the beginning of its operation – Internal Quality Control that checks the variability of measurements, when the same person performs the same measurement as well as the variation of measurements performed by different members of the laboratory. Zeginiadou-Andrology laboratory also participates in the External Quality Control system of SIGA-ESHRE continuously since 1999, which is the only way to ensure the reliability of the laboratory result. At the same time Zeginiadou-Andrology laboratory also has the certification of the quality management system in health EN 15224: 2017, which ensures the best provision of services in the field of health.
CAN SEMEN ANALYSIS GIVE INFORMATION ABOUT PRESENCE OF INFECTION?
The semen analysis can give information related to infection. For many years signs of infection were considered the increased pH, the increased viscosity and the presence of increased numbers of white blood cells. The pH, according to the guidelines of the World Health Organization (WHO, 2010) has no upper value, so an increased pH is no longer abnormal and thus cannot be considered as a sign of infection. Nowadays the only essential sign in the sperm sample is the presence of increased numbers of white blood cells.
The Parameters Of Semen Analysis
Instructions Before The Semen Analysis