It is estimated that 20% of infertility cases are due to a male factor, while 30% of cases result from a combination of both male and female factors.
Sperm analysis is therefore an essential step in the investigation of infertile couples.
1. Semen Analysis (Spermogram)
A spermogram evaluates the physicochemical properties of an ejaculated semen sample.
Semen is collected by masturbation in a laboratory setting after an abstinence period of 2 to 5 days.
Sperm parameters can fluctuate between tests because sperm production occurs in cycles, renewing every 74 days. For this reason, it is recommended to wait 2 to 3 months before repeating the test to obtain a reliable assessment.
Certain acute health conditions can temporarily impact sperm quality. High fever, dental infections, or recent surgery can cause a sudden decline in sperm parameters. Therefore, a follow-up test should always be performed at a later stage before concluding that sperm abnormalities are permanent.
1.2 Migration-Survival Test
This test is commonly performed alongside the spermogram using the same semen sample, if requested by the prescribing physician. Rather than serving as a diagnostic tool, it is primarily a therapeutic test. The process involves centrifuging the sperm through a density gradient to isolate the most viable and motile spermatozoa. The results help determine the most suitable technique for medically assisted reproduction. Depending on the outcome, the recommended approach may involve intrauterine insemination, in vitro fertilization, or intracytoplasmic sperm injection.
1.3 Sperm Culture – Urine Analysis
This is a bacteriological examination of the semen. Although often asymptomatic, the presence of bacteria in sperm can explain abnormalities such as leukospermia, which is a high white blood cell count in semen, necrospermia, which affects sperm viability, or asthenospermia, which reduces sperm motility.
To ensure comprehensive screening, sperm culture should be combined with an analysis of the first urine stream to detect infections caused by Chlamydia or Gonococcus.