Sperm examination

Disordered sperm cell maturation: the most common cause of reduced fertility in men

The production of sperm cells starts during puberty and takes place in the testicles. This process is regulated by the sex hormone FSH (follicle stimulating hormone), which stimulates the production of millions of sperm cells every day. After roughly ten weeks, the sperm cells move from the testicles to the epididymis for the final stage in their maturation. If the maturation of the sperm cells is disordered or disrupted, either there won’t be enough sperm cells or the sperm cells will not be agile enough. This decreases the odds of the sperm cells reaching the oocyte located in the woman’s fallopian tubes.

A fully functioning sperm transport is essential to conceive

During ejaculation, the sperm cells move from the epididymis to the vas deferens and through the urethra, they enter the woman’s vagina. Through the uterus, the sperm cells move to the fallopian tube, where the oocyte is located. In some cases, there are enough agile sperm cells, but they may be unable to enter the woman’s body, for example, due to a blockage of the vas deferens. This is the cause of reduced male fertility in roughly 4% of cases. A blockage of the vas deferens can be something that you were born with, or it might be the result of earlier sterilization. Epididymitis (an infection of the epididymis) may also cause a blockage of the vas deferens.

During a semen analysis, the number of sperm cells and the quality of the semen are determined

If you come into our clinic because you are unable to have children as you wish, a semen analysis is usually one of the first diagnostic actions we take. During one, a sperm sample is examined microscopically in our specialized laboratory as soon as it is obtained (within 60 minutes). The ejaculate is inserted into a special counting cell and analyzed using a microscope. During the examination, we determine the volume of the ejaculate, the number of sperm cells and their agility and shape.

Volume of the ejaculate: usually, this is over 1.5 millilitres

Concentration (number of sperm cells in each millilitre of fluids): usually, there are over 15 million sperm cells in one millilitre

Motility (the sperm cells’ agility):

This is subdivided into several classes:

• Class A (fast progression forward)

• Class B (slow progression forward)

• Class C (agile in place)

• Class D (unmoving)

Usually, over 32% of the sperm cells in the sample should have a higher motility (Class A and/or B)

Morphology (the sperm cells’ shape): Usually, over 4% of the sperm cells in the sample should have a normal shape

pH (acidity): Usually, this is higher than 7.2

Agglutination (clumping of sperm cells): Usually, this doesn’t happen.

MAR test or Immunobead test (tests whether a man produces antibodies against his own sperm): This should be beneath 40%

Vitality (number of live sperm cells): This should be over 75%

If the semen analysis doesn’t meet these criteria, reduced male fertility could be involved in you and your partner’s inability to conceive. If this seems to be the case, a semen analysis will usually be repeated a few weeks down the line. If the analyses repeatedly indicate reduced fertility, we’ll advise you thoroughly regarding fertility treatment options. Our physicians will gladly provide extensive advice regarding this and other subjects.

What can cause reduced sperm quality?

A disordered sperm cell maturation process can be either temporary or permanent, and it can be caused by either a congenital defect or an illness. The most common causes include:

• An unhealthy lifestyle (such as smoking, use of alcohol, obesity, use of medications, exposing the testicles to high temperatures)

• A fever at any point during the three months prior to the sperm analysis

• Varicocele (varicose veins in the scrotum)

• Undescended testicles

• Surgically removed tumours

• Hormone imbalance

• Genetic causes

• Stress and pollution

  
  Regarding our diagnosis protocol: our physicians will take into account all possible causes of a fertility disorder, and they will recommend the necessary treatment.