Seminal Analysis
Spermogram and seminal analysis are terms that are usually used interchangeably. Androscience agreed to call the exam that assesses minimum parameters of the ejaculated semen as spermogram, while it calls manual seminal analysis and manual seminal analysis completes the exam that assesses, in addition to the minimum parameters required by the World Health Organization (WHO), some important additional parameters when seeking a male diagnosis.
It is important to know that neither a sperm analysis nor a seminal analysis is able to determine a man's fertility or infertility. For a deeper evaluation, there are sperm function tests. The investigation of semen works as a marker of testicular function and, for this reason, it is important in the assessment of human health in a more global way.
HOW THE TEST IS CARRIED OUT
Semen evaluation must be done carefully, as it provides important information about spermatogenesis and the permeability of the reproductive tract. Traditionally, the diagnosis of male infertility depends on a descriptive assessment of the parameters of the ejaculate, with an emphasis on sperm concentration, motility and morphology. The fundamental philosophy of this approach is that male fertility can be defined in terms of a minimum number of morphologically normal and progressively moving sperm, which must be exceeded for a given individual to be diagnosed with normal spermatogenesis and greater chances of pregnancy.
Cytogram generated by SCSA® software. The more dispersion
there are to the side (axis “fragmented DNA), the greater the index of
fragmentation of sperm DNA.
Adapted from EVENSON, Donald P. The Sperm Chromatin
Structure Assay (SCSA®) and other sperm DNA fragmentation
tests for evaluation of sperm nuclear DNA integrity as related to
fertility. Animal reproduction science, v. 169, p. 56-75, 2016.
STEP 1: SAMPLE COLLECTION
The collection of the semen sample usually used, suggested by the World Health Organization and which guarantees the effectiveness of the result of the effective seminal analysis, is the collection by self-masturbation. For this collection, a period of ejaculatory abstinence of 2 to 7 days is suggested. The Androscience laboratory has a secret collection room, prepared for the comfort of the patient during the procedure.
In exceptional cases, such as patients who are in a hospital bed, Androscience provides the service validated by the Sanitary Surveillance for transporting biological material.
Another option offered, however, not recommended because it does not guarantee the quality of the sample during the analysis, is the collection of samples at home using specific sterile condoms and without spermicides.
STEP 2: SAMPLE LIQUEFACTION AND MACROSCOPIC ANALYSIS
Immediately upon receipt of the sample by the laboratory staff, the sample is kept warm.
When ejaculated, the semen is quite viscous, due to the presence of special proteins, which change their structure when exposed to room temperature, in such a way that the semen normally completely liquefies within 60 minutes.
Liquefaction, however, typically takes 15 minutes. In some cases complete liquefaction does not occur within 60 minutes and this may indicate prostate dysfunction.
The evaluated macroscopic parameters are:
Seminal volume: Seminal fluid or fluid is the means of transport and nutrient source for sperm to remain alive within the female reproductive tract. Normal ejaculate volume is ≥ 1.5 ml. Changes in seminal volume may suggest infection, inflammation or abnormalities in the male reproductive tract organs, long periods of abstinence, use of antibiotics, retrograde ejaculation, ejaculatory duct obstruction, or agenesis/hypoplasia of seminal vesicles.
Appearance/Color: A normal specimen has a homogeneous appearance and an opalescent gray color. The sample may also appear reddish, suggesting the presence of blood in the semen, prostate cancer or prostatitis, or yellowish, suggesting infection.
Viscosity: Increased viscosity of the seminal sample may be related to prostatic dysfunction due to chronic inflammation or dysfunction of the seminal vesicles. Abnormal consistency may also impair the assessment of other semen characteristics, such as motility, concentration or determination of antisperm antibodies.
pH: It is important that the semen pH is basic (above 7.0) to neutralize the acidic vaginal pH, keeping sperm alive. It is suggested that samples with a pH greater than 7.8 should be evaluated for the presence of infection or prostatitis. In cases where the pH is lower than 7.2, agenesis or occlusion of the seminal vesicles and ejaculatory duct obstruction may be suspected.
References:
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Evenson DP, Higgins PJ, Grueneberg D, Ballachey BE. Flow cytometric analysis of mouse spermatogenic function following exposure to ethylnitrosourea. Cytometry. 1985;6(3):238–53.
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Hallak, J., Pariz, JR The Role of the Andrologist in an Intrauterine Insemination Program in Intrauterine Insemination (pp,483-500), 2013. Edition: 3rd edition Publisher: Jaypee Brothers Medical Pub - ISBN: 978-9350904039
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Evenson DP. The Sperm Chromatin Structure Assay (SCSA®) and other sperm DNA fragmentation tests for evaluation of sperm nuclear DNA integrity as related to fertility. Anim Reprod Sci. 2016; 169:56-75.
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Hallak J. Utility of sperm DNA fragmentation testing in different clinical scenarios of male reproductive abnormalities and its influence in natural and assisted reproduction. Transl Androl Urol. 2017b;6(4):S509-S512.