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The seminogram is a basic diagnostic test that analyzes multiple parameters (macroscopic and microscopic) of a semen sample.

It covers two areas:

• Macroscopic: observation of liquefaction, viscosity, appearance, volume, and pH.
• Microscopic: sperm motility, sperm concentration, sperm morphology, presence of aggregates, vitality, and presence of leukocytes.

By analyzing all the mentioned parameters, the patient’s fertility potential can be determined. However, a semen sample within normal values does not necessarily mean it is 100% capable of producing a live child at home after assisted reproductive techniques.

Sperm concentration and motility are two crucial values when evaluating a semen sample and the patient’s fertility potential.

Sperm Concentration

The concentration determines the number of sperm present in a given volume of semen (regardless of motility). Various sperm counting devices exist:

• The Leja chamber.
• CellVu
• Petroff Hauser
• The Neubauer chamber
• The Makler chamber

Thus, knowing the sperm concentration and the total volume of the sample, the total number of sperm in the ejaculate can be determined. This value reflects sperm production in the testes and the patency of the post-testicular system.

The diagnosis is based on the World Health Organization (WHO) 2010 criteria:

• Normozoospermia: if the sperm concentration is equal to or greater than 15 million per ml or has a total sperm count equal to or greater than 39 million.
• Oligozoospermia: if the sperm concentration is less than 15 million per ml.
• Azoospermia: if no sperm are observed either fresh or post-centrifugation (at 1,500 rpm for 10 minutes).
• Cryptozoospermia: if no sperm are observed fresh but are observed post-centrifugation.

Sperm Motility

Sperm motility is a key parameter for selecting the best sperm. This motility is acquired when sperm transit through the epididymis, which secretes the protein FMP (forward motility protein).

It has been observed that sperm with better motility have a higher chance of fertilizing the egg, both in an Artificial Insemination and in conventional IVF.

Sperm motility is usually classified into 4 movement categories:
– Rapid progressive motility or type a: sperm moving 25 μm or more per second.
– Slow progressive motility or type b: sperm moving between 5 and 24 μm per second.
– In situ motility or type c: sperm moving less than 5 μm per second.
– Immobility or type d: completely immobile sperm.

The diagnosis is based on the World Health Organization (WHO) 2010 criteria:

• Normozoospermia: if the total motility percentage (a+b+c) is equal to or greater than 40% and if the progressive motility (a+b) is equal to or greater than 32%.
• Asthenozoospermia: if the progressive motility percentage (a+b) is less than 32%.

If you want to learn more about the most common diagnoses after performing a seminogram, check out this post where we explain what Teratozoospermia is.