Routine sperm analysis
A number of tests are designed to determine the quality of your sperm and sperm production. They are all based on the analysis of a sperm sample, which all take place in the Andrology lab.
You can produce a sperm sample at the CRG (in a designated room set aside for this purpose) or do it at home and bring it with you (see practical information
). In this case, it is crucial for the test results that you ensure the arrival of your sperm sample in the centre within an hour
of its' production and that it is kept at body temperature in the meantime. It is also important that you catch the whole of the ejaculate. If that is not the case, you must inform us.
The results of your sperm analysis will be discussed with you by your doctor at consultation.
Routine sperm analysis
This test is performed for every man who comes to the CRG for fertility treatment.
It is carried out according to strict methodology of the WHO, which dictates standard methods relating to the collection of the sample, the delivery thereof to the laboratory and the following laboratory procedures. The various stages of the procedure can be seen on the 'Comhaire scheme'. See also sperm quality
for the parameters to which the sperm sample must confirm to, to be regarded as fertile.
What does a routine sperm analysis determine?
- the concentration of sperm cells within the ejaculate;
- the motility of the sperm;
The above actions take place in the counting room.
- the form of the sperm;
- the vitality of the sperm: which percentage is alive. Not all immobile sperm are necessarily dead.
- the volume of ejaculate. 2ml is the minimum.
- the acidity (pH) and viscosity of the sample.
- the number of white blood cells (peroxidase test): too many may be an indication of infection, in which case the semen will be placed in culture to determine the nature of infection with a view to treating it.
the sperm is brought to the counting room.
counting sperm under the microscope.
counting device for sperm.
sperms are stained to be able to determine their shape and form.
Acrosome reaction test (ARIC)
A sperm must demonstrate an acrosome reaction if it is to be able to penetrate an egg. Biochemical substances are released to make this possible. This test determines whether or not the sperm has this ability. It is a highly specialized test and difficult to standardize.
Biochemical sperm markers (fructose and alfa-glucosidase)
This test is used in azospermia cases to try to establish why the ejaculate contains no sperm. This does not always mean that none have been manufactured or ripened; they could be obstructed somewhere between the testicle and the point of ejaculation.
The procedure is scientifically based upon the fact that semen is enriched with nourishing substances such as alfa-glucosidase from the epididymis and fructose, which is added as the sperm passes the seminal vesicles and prostate. By determining which of these substances are present in the sample, it is possible to diagnose where the blockage occurs.
During fertility treatment, sperm is examined in order to make use of only the highest quality and most motile sperms available in the mans' sample.
Computer controlled motility analysis of sperm
This test is a more thorough form of motility analysis than performed during routine analysis, because it is computerized.
Sometimes it is necessary to perform an examination under an electron microscope, thus enabeling conclusions regarding a particular phenomenon. This is true in the case where a sperm sample contains exclusively immobile, but nevertheless live sperm. This could be an indication of the rare 'Carthagener Syndrome' in which the tails on the sperm are paralyzed. Only by means of an electron microscope is it possible to visualize the unimaginably small structures responsible for movement.
FISH-analysis upon sperm
With this highly specialized test (FISH stands for fluorescent in-situ hybridization) it is possible to make a chromosomal analysis of sperm cells. It is performed under certain conditions, for example if there is a large occurrence of abnormal embryo's resulting from IVF in a couple having fertility treatment.
Hypo-osmotic swelling test (HOS-test)
The HOS-test is a specialized vitality test which establishes whether immobile cells in a sample are dead or alive. It is performed when a sample contains an unusually high number of immobile sperm, sometimes based also on clinical indications. Sperm are place in a preparation which contains few molecules and is coloured red. This causes the live sperm to swell and become red, and the dead ones to shrink. The living ones are thus easily identifiable.
This test, which is a more detailed version of the one performed as part of the routine analysis test, determines the sperms' vitality. They are placed in a medium to see how long they stay alive.
The Mixed Anti-globulin Reaction test
is in principle part of the routine analysis test, but is not always included in the test. It determines whether the man produces antibodies against his own sperm (see immunological analysis
Antibodies cause the sperm to stick to each other.