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Spermiogram is an ejaculate analysis that determines the total number, concentration, mobility and appearance (morphology) of sperm. In the diagnosis of male infertility, this is the basic examination on the basis of which the further course of action in the treatment of the infertility couple is decided.

When to do spermiogram (sperm analysis)?

Sperm analysis (spermiogram) is done when couple is undergoing infertility treatment (if after one year of trying, the desired pregnancy has not occurred, you should inform your doctor for consultation and preliminary examinations, if you are older than 35, then this period is 6 months.) or if your urologist indicated you need to do it.


It is suggested by WHO (World Health Organisation) for spermiogram to give reliable results to get prepared correctly:

  • Sexual abstinence for 2-4 days before exam
  • Collecting the sample in sterile container
  • Delivery of material immidiately after collection or within 1 hour (making sure that is not undergoing temperature changes)

What parameters are evaluted

When the sample is taken variuos components and characteristics will be analyzed in the labratory, with the aim of giving a general picture of fertility and male health.

In Polyclinic Cito analysis is done with SCA CASA System that allows accurate, repetitive and automatic assessment of the following sperm parameters: motility, concentration, morphology, DNA fragmentation, vitality, acrosome reaction and leukocytes.


How are the results of Spermiogram (sperm analysis) interpreted?

According to the Spermiogram analysis results, the following conditions may be detected:

  • Aspermia: complete lack of semen after ejaculation.
  • Azoospermia: absence of sperm cells in the semen sample.
  • Cryptoazoospermia: presence of very few sperm cells in the ejaculate but only after centrifugation of  the sample.
  • Hypospermia: small sperm volume.
  • Oligospermia: Low sperm count (<15Χ10sperm cells/ml or <39Χ106sperm cells in total, according to the latest WHO Guidelines 2010).
  • Asthenospermia: reduced sperm motility (<32% rapid progressive motility, according to the latest WHO Guidelines 2010)
  • Teratospermia  High number of sperm cells with abnormal morphology (<4% sperm cells with normal form, according to the latest WHO Guidelines 2010).
  • Necrospermia: presence of only dead sperm cells in the sample.

Other equally important results are:

  • Acidity (pH): ≥7.2
  • White blood cells: 1Χ106
  • Sperm agglutination (sperms that clump or stick together) <50%

Tests and procedures to treat male infertility

DNA fragmentation test

Sperm DNA fragmentation is a natural and normal phenomenon that occurs as a result of programmed sperm death (apoptosis) and if observed in approximately 30% of sperm has no significant effect on male fertility.

Sperm DNA fragmentation is one of the first signs of sperm deterioration and cannot be related to common semen analysis parameters such as sperm number, concentration, and motility.

This test is extremely useful and helps determine the answers to the following questions:

  • which pairs are suitable for AIH
  • should a modified approach (PICSI, IMSI) be applied to ICSI
  • whether varicocele surgery was effective
  • how much damage was caused by Chlamydia and Mycoplasma infection
  • which is why the failure of MPO procedures is repeated in some couples

Micro TESE

In male patients with azoospermia (absence of sperm in the semen sample), the micro TESE procedure is used, in which the testicular tissue with sperm is extracted with a small incision or needle. The obtained spermatozoa can be used for in vitro fertilization.

After the diagnosis of azoospermia, MicroTESE is recommended for:

  • Male patient that has an adequate level of testosterone in his blood after a hormone test another exams indicating that his testicles are not making normal amounts of sperm
  • If patient remains azoospermic even though he has received treatment and his testosterone levels have been normal for last four months
  • Obstructions of the excretory ducts of the testicles, when the sperm produced by spermatogenesis cannot exit the testicles
  • The mikroTESE method can also be used when there are sperm in the ejaculate, but their quality is poor

During microTESE procedures, in non-obstructive azoospermia, sperm can be found in 50-65 percent of cases. In obstructive azoospermia, sperm are always found in the testicles.

What makes MicroTESE successful?

In order for MicroTESE to be successful, a skilled urologist and an excellent embryologist are needed to examine the extracted samples. If sperm are found, they will be frozen for use in future IVF attempts.

The mikroTESE method can also be used when there are sperm in the ejaculate, but their quality is poor

Recovery after MicroTESE procedure

After the procedure, the doctor will prescribe painkillers if necessary. Patients will be asked to avoid sexual intercourse, masturbation and exercise for 10 days after the procedure.

If you have any questions about spermiogram (male fertility analysis), DNA fragmentation test or microTESE, we offer free consultations with our clinical embryologists.

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