Spermiogram

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 29.10.2020

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Synonym(s)

Sperm biocytogram

Definition
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Totality of the findings of an ejaculate examination in men with the question of fertility.

General information
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At least 2 spermiograms at intervals of 7-21 days required to assess intra-individual variations in quality Assessment of ejaculate according to WHO normal values (see Table 1) for:
  • Viscosity
  • Liquefaction
  • Volume (reduces during stress and retrograde ejaculation)
  • pH value (1 hour after ejaculate extraction; pH indicator paper with measuring width 6.4-8 and 6.1-10)
  • Number of spermatozoa (possibly after centrifugation; azoospermia only if no spermatozoa are visible after centrifugation)
  • Sperm morphology (sperm head, middle part, tail) according to WHO criteria:
    • Abnormal shape and/or size of the sperm head: Large heads, small heads, vacuoles (> 20% of the head surface), hyperextensions (cigar-shaped, pear-shaped), amorphous, double heads.
    • Defects of the neck or middle part: absence of the tail, irregular base of the flagellum with folds, defects in the shape of the middle part (irregular shape, folds, dilated, thin).
    • Tail defects: Flagellum too short, variations in calibre, kinked flagellum, rolling of flagellum, double/multiple tails.
    • Cytoplasmic drops (> 1/3 of the sperm head).

Indication
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Implementation
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After a standardized sexual leave of 5 days, the ejaculate is freshly obtained by masturbation and examined in the andrological laboratory.

Literature
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  1. Köhn FM, Haidl G (2002) Andrological diagnostics. dermatologist 53: 761-779
  2. Rowe PJ et al (2000) WHO manual for the standardized investigation, diagnosis, and management of the infertile male. Cambridge University Press, Cambridge
  3. WHO (1999) Laboratory Manual for the Examination of Human Ejaculate and Sperm-Cervical Mucus Interaction, 4th ed. Springer, Berlin, Heidelberg, New York, Tokyo
  4. Wolff H et al (1994) Andrologic variables for in vitro fertilization. dermatologist 45: 605-610

Tables
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Parameters

Normal values

Volume

≥ 2 ml

Viscosity (thread length of a falling drop)

< approx. 2 cm

pH

≥ 7.2-7.8

Liquefaction

after 60 minutes at the latest.

Sperm concentration

≥ 20 million/ml

Total number of spermatozoa

≥ 40 million/ml

Motility

≥ 50% (WHO a+b) or 25% (WHOa)

Morphology

≥ 15% Normal forms

Proportion of vital spermatozoa

≥ 50%

Peroxidase-positive cells (leukocytes)

≤ 1 million/ml

Ejaculate fructose

> 120 mg/dl

Authors

Last updated on: 29.10.2020