Sperm analysis is the first and most important examination for the investigation of male fertility. This examination can offer valuable data for assessing fertility, testing a wide variety of important sperm parameters. The only prerequisite before the examination is abstinence of 2-4 days. The sample may be collected at the IVF clinic, or at home, in a special sterilised beaker. In case of sperm collection at home, the sample must immediately be transferred to the andrology lab (within an hour) in temperature of 18 – 30o C.
The sperm parameters that are assessed in a sperm analysis is the total sample volume, the pH, the sperm concentration, the total sperm number, sperm motility and morphology, as well as the presence of “round cells”. The examination of the previous factors is in accordance with the strict criteria of the World Health Organization (WHO, 2010). A normal sperm sample is liquefied within 15-20 minutes and its minimum volume is 1.5 ml. The sperm concentration should exceed 15 millions /ml and the total sperm number should be over 39 millions, as these are the lower reference limits.
In order to assess the motility of the sperm, spermatozoa are considered to be divided in three categories. The first category includes spermatozoa with progressive motility, the second one includes those with non-progressive motility and the third category includes the non-motile spermatozoa. The lower reference limit in a normal sperm sample is 40% for spermatozoa of progressive and non- progressive motility in total and 32% of spermatozoa with progressive motility.
The assessment of the morphology is a really important factor for male fertility, as well, as it has been shown that is strongly associated with infertility cases. The evaluation of the sperm morphology is possible after a specific staining and observation of the sample under the microscope. The abnormal morphology of sperm concerns the shape of the head, the neck and the tail. The lower acceptable percentage of normal spermatozoa in a semen sample is 4%. The evaluation of the previous factors in total is based on the assessment of quality and quantity parameters of the sperm. Sperm analysis is usually a necessary tool in the primary investigation of male fertility, as it provides useful information for a couple’s case.