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Semen pathology what. Seed plasma, its composition and pathology. What will the spermogram show?

In men who have been prescribed a study of seminal fluid, the question may arise, why do they take a spermogram ?

♦ doctors use this test to diagnose male infertility when a married couple cannot conceive a child for a long time. This is especially true if a man has suffered any disease of the reproductive system (prostatitis, chlamydia, varicocele).

♦ to monitor the ongoing treatment of infertility.

♦ before carrying out artificial insemination (ICSI or IVF).

♦ it is given to sperm donors and people who want to use ejaculate cryopreservation.

Normal indicators seminal fluid

What does the semen analysis show?

• Semen volume (2 ml or more).
• Total sperm count (39 million or more).
• Sperm concentration (15 million in 1 ml or more).
• Sperm motility (from 40% or more).
• Sperm count with progressive movement (32% or more).
• Sperm viability (from 58% and more).
• The number of normal forms of sperm (from 4% or more).

Semen pathology

In male infertility, spermogram analysis makes it possible to determine pathological changes in the ejaculate. These include:

• Decreased sperm concentration.
• Decreased mobility.
• Decrease in normal forms.
• Complete absence of sperm.
• Decrease in ejaculate volume.
• Lack of ejaculate.
• An increase in leukocytes in the ejaculate.
• Lack of sperm motility.
• Lack of live sperm.
• The presence of blood in the semen.

What does the spermogram show and how are all laboratory studies of the semen performed? First of all, it is necessary to determine the main indicators of the analysis and evaluate their result.

Semen volume

The volume is measured using a special pipette with a scale. An amount less than 2 ml is pathological, this condition is called oligospermia. Ejaculate consists of prostate juice and seminal vesicle juice.

A decrease in the value can be affected by diseases of the reproductive system (dysfunction of the seminal vesicles and prostate gland, obstruction of the vas deferens, hypogonadism) and improper preparation for the study.

Sperm count

In the laboratory, it is necessary to determine the absolute (total) and relative (in 1 ml) sperm count. For this, a microscopic method is used using special counting chambers.

The laboratory assistant makes a smear of a drop of ejaculate and counts the number of sperm in the field of view by eye. There are sperm analyzers - computerized automatic counting systems. Their plus is the reduction of the human factor, ease of use and faster research.

After obtaining the relative values ​​in 1 drop, you can multiply the result by the total volume and get the absolute sperm count. A decrease in these indicators is called oligozoospermia.

Sperm motility

For male reproductive cells to reach and fertilize an egg, they must be mobile. There are 4 categories of mobility:

• A - progressively active moving, speed more than 25 microns per second, rectilinear movement.
• B - progressively weakly mobile, the speed is less than 25 microns per second, the movement is rectilinear.
• C - non-progressive-mobile, non-linear movement or in place.
• D - motionless.

Determine the mobility microscopically or using sperm analyzers. Normally, category A should be 25% or the sum of categories A and B 50%. The condition when these conditions do not correspond to the norm is called asthenozoospermia.

Viability

It is characterized by the number of living spermatozoa relative to dead ones. Normally, they are at least 50% of the total number. To determine living cells in laboratory conditions, two methods are used:

• Supravital eosin staining. Eosin is a dye that can penetrate the broken membrane of dead spermatozoa, but does not penetrate the wall of living sperm. In this case, dead bodies turn pink. When using this method, 1 drop of semen is mixed with 1 drop of a 0.5% dye solution, after which a slide with a smear is viewed under a microscope and the number of stained cells is counted.
• Hypoosmic test. This technique is based on the property of normal spermatozoa to swell in a hypotonic solution. 1 drop of semen is mixed with 10 drops aqueous solution fructose and sodium citrate. Then this mixture is placed in a thermostat with a temperature of 37 ° C for 60 minutes. Then microscopy is performed and the number of unchanged cells is counted.

If there are no living cells in the ejaculate, this is called necrozoospermia.

Sperm morphology

In addition to motility, it is necessary to determine the number of normal sperm cells. A microscopic method is used, in which it is necessary to determine the proportion of normal cells. For convenience, watch a regular smear or stain with special dyes. With pathology, the head, neck or flagellum may change. Any change in morphology is called teratozoospermia.

How to donate semen correctly

Before any medical examination, proper preparation is required and spermogram is no exception.

First you need to properly prepare for sperm donation.

1. a man needs to comply sexual abstinence from two to four days. If less than two have passed since the last ejaculation, then the volume may be less than the actual one. If more than four, then cell mobility may decrease.
2. it is not recommended not to overheat for a week (bath, sauna, take hot baths) and overcool. Such temperature influences can negatively affect spermatogenesis.
3. it is undesirable to consume alcoholic beverages and, if possible, not to take medications, especially those that negatively affect the reproductive system.

It is necessary to donate sperm in specialized clinics. Delivery is made only by masturbation with ejaculation in a special sterile plastic container.

It is not allowed to donate semen using interrupted intercourse or semen from a condom.

Immediately after delivery, it is necessary to deliver the ejaculate to the laboratory as early as possible. The container must be transported carefully, without physical external influences. The analysis must be passed 2-3 times in 1 month to identify a pathological condition, and not an accidental failure in spermatogenesis.

Conclusion

What is a spermogram for? This is important research that will help many married couples who want to have a child, but cannot do it and do not know what the problem is. Modern medicine has the ability to help such people, but first you need to identify the cause of the problem, for this, doctors use a spermogram. it is not difficult to pass it, but for the correct interpretation of the result, you need to properly prepare for it.

Now you know what the spermogram shows , how to get tested and you can independently understand the meaning of the medical report. Thank you for the attention!

The process of treatment should begin with clarifying the diagnosis. The spermogram, which is prescribed during the examination, gives the doctor a lot of information about the patient's germ cells. In most cases, the pathology that causes infertility is reflected in the test results.

Decoding spermogram and types of sperm pathologies

Normal sperm counts are considered:

• acidity from 7 to 8;
• volume - at least 2.5 ml;
• liquefaction time - up to 1 hour;
• semen viscosity - 2 cm;
• the total number of spermatozoa is 60,000,000 and more;
• the level of mobility is expressed by letter designation (A - motile and fast spermatozoa; B - movement is present, but slow (nonlinear, linear); C - cells move only in place; D - motionless spermatozoa).
• the presence of at least 25% of type A cells and more than 50% of A + B.
• from 30 to 70% of sperm without pathologies;
• leukocytes in semen - 10 6 in 1 ml;
• lack of agglutination process, erythrocytes;
• epithelial cells - in a single number, and spermatogenesis cells - no more than 4% of the total.

During the study, the following forms of sperm pathology can be identified:

• Azoospermia- is diagnosed in the absence of sperm in the material taken. It can be obstructive (there are sperm in the testicles, but they are not ejaculated due to obstruction of the vas deferens) and secretory (there are no sperm in the testicles).
• Asthenospermia- sedentary male reproductive cells. The diagnosis is established if there are more than 60% of unhealthy sperm in the analysis.
• Pyospermia- This is the presence in the semen of a large number of leukocytes and pus, which indicates an inflammatory process in the genitourinary system.
• Teratospermia- detection in the analysis of a large number of pathological spermatozoa from a morphological point of view.
• Anejaculation- this is the complete absence of ejaculation in a man.
• Necrospermia- non-living sperm in semen.
• Oligospermia- Insufficient semen volume during ejaculation.
• Cryptospermia- detection in the analysis of motile spermatozoa in a single number.
• Oligozoospermia- the number of spermatozoa in the ejaculate is less than 15,000,000 in 1 ml.

Classic methods of treating infertility in men

The type of treatment depends on the cause of infertility, which is divided accordingly into such types:

• surgical;
• auxiliary techniques;
• hormonal;
• treatment of sexual dysfunctions;
• medication;
• physiotherapy.

Surgical treatment of infertility in men

It is resorted to if the cause of infertility is - tumor-like swelling of the veins that ensure the outflow of blood from the testicle. The varicose veins of the spermatic cord are removed through surgery, due to which the blood flow in this area is normalized.

Important: surgery for varicocele will be effective only if it is performed on time. When the testicles atrophy due to the lack of normal local circulation, it is almost impossible to return the man's ability to conceive.

Surgical treatment is also indicated for obstructive infertility, when there is obstruction of the spermatic cords due to trauma, orchitis, (in childhood). During this intervention, the surgeon restores the patency of the vas deferens by removing the obstructed segment or creating a new one. The success of the operation depends entirely on the length of the pathological part of the cords, which must be removed or replaced.

Conservative therapy of infertility in men

This method is used in the case of immune, hormonal or secretory infertility. Only a doctor is competent to prescribe certain drugs and their dosage after confirmed infertility in a man.

In particular, after identifying the causes of the disease, the following means can be used:

Note:for male infertility treatment folk remedies cannot replace the main one. In particular, in this respect, the hirudotherapy method is quite popular among patients. It can be used only in combination with other techniques, taking into account the fact that there are rather contradictory opinions about its effectiveness among doctors. Leeches are used to improve local blood circulation and the process of spermatogenesis, but in case of male infertility, treatment with folk remedies should be agreed with the attending physician.

Physiotherapy

In case of infertility, the following local procedures are prescribed:

• electrophoresis;
• laser;
• transurethral microwaves;
• phonophoresis.

Physiotherapeutic treatment has a positive effect on the trophism of the prostate, blood supply to the genitals, productivity and quality of sperm, eliminates latent inflammatory processes.

Treatment of sexual dysfunctions

Erectile dysfunction is medically treated by taking a group of PDE-5 inhibitors, such as:

• levitra;
• Viagra;
• cialis.

It is also practiced to administer Alprostadil into the urethra and intracavernous injections.

If the drugs do not give an effect or the patient has contraindications for taking them, then they resort to a surgical solution to the problem:

• local embolization of arteriovenous shunts;
• implantation of a penile prosthesis;
• endovenous stenting of the penile arteries;
• vacuum constriction.

Premature ejaculation is treated with the compression technique and stop-start (delayed ejaculation). Among the medicines used are centrally acting agents (tramadol, clomipramine, fluvoxamine, fluoxetine, paraxetine, sertroline). Vasoprostan, Emla cream, etc. are applied locally. As an operative treatment resort to neuroectomy of the dorsal nerve of the penis, selective resection of the spinal nerves.

Assisted reproductive treatments for male infertility

They are used when the obstruction of the vas deferens cannot be corrected, in the presence of retrograde ejaculation and other similar problems that cannot be cured. Among the most popular methods, most often they resort to infertility. An ovum is removed from a woman's ovary, and in a laboratory it is fertilized with sperm taken from a man's testicle or bladder.

Modern reproductive technologies

It should be understood that these techniques are used for severe male infertility or an incurable form. But even in this case, modern medicine can give a man a chance to become a father of his own healthy child.

Male infertility treatment with TESA method

This technology is used in the complete absence of sperm in the patient's semen. It is performed as a needle biopsy under visual control in areas of active spermatogenesis. Testicular puncture is performed very carefully to take the required amount of materials.

ICSI

This is a procedure for the selection by the embryologist of the correct one, taking into account the morphological parameters of the sperm. He is immobilized, placed in a thin needle, which is inserted into the egg. Thus, fertilization takes place.

PICSI technology in the treatment of male infertility

It is considered an advanced technique, as it implies a clear and competent selection of sperm for fertilization. PICSI preselection is based on the selection of male sex cells, taking into account their characteristics of behavior in an environment that is as close as possible to the egg cell. The method is advisable to apply in case of male infertility, unsuccessful IVF attempts (2-3 times), low quality of embryos.

IMSI

It is an innovative method of fertilizing an egg in the treatment of male infertility. Sperm cells undergo a very careful selection by selection under multiple magnification (x 6300). The embryologist selects the best sperm cell through a digital image that is displayed on a monitor. After that, it is injected directly into the egg itself, which significantly increases the success of fertilization, and the chance of pregnancy increases to 70%.

More detailed information on sperm pathologies and modern methods of treating male infertility is presented in the video review:

Julia Viktorova, obstetrician-gynecologist

One of the most common causes of infertility in men is the pathology of the sperm head. This is a morphological violation of the structure of the head of the sperm. An anomaly in the structure of spermatozoa is shown by a spermogram. Consider the causes of deviations, methods of therapy and prevention.

What does head pathology mean in spermogram? To conceive a child, a man's sperm must contain a sufficient amount of healthy sperm - at least 50%. Ugly sperm (), determined by analysis, is an obstacle to fertilization of female eggs. As a rule, in men with this diagnosis, 80% of spermatozoa have an abnormality in the structure.

Causes of pathology:

• hormonal disruptions;
• genetic predisposition;
• age-related changes;
• - expansion of the veins of the scrotum;
• trauma to the scrotum;
• bad habits - alcohol / tobacco;
• environmental impact.

The hormonal background can be disrupted due to physical and mental overwork. Stress, unfulfilled obligations and the burden of responsibilities have a negative impact on human health. Also, the hormonal background can change under the influence of infectious diseases.

What is genetic predisposition? This is an inherited anomaly in the structure of the sperm. Genetics is transmitted in 95 cases out of a hundred.

With age, the body undergoes qualitative changes, which also affects the sperm. After the male menopause, the ejaculate has a pathological structure due to the cessation of the production of testosterone and androgen.

Varicocele is another cause of semen abnormalities. Due to the expansion of the veins of the scrotum, the quality of the ejaculate suffers.

How can injuries affect sperm formation? It turns out that they are capable of provoking teratozoospermia. Injuries include bumps, cuts, and even surgery.

Alcohol and tobacco addiction contribute to the formation of quality sperm. Nicotine destroys the protective layer, lowers the immune system. Alcohol interferes with the production of enough male hormones. The result is teratozoospermia.

Note! In some cases, conception becomes possible, but the child is born with pathological abnormalities.

What does deformed sperm look like? The head has a reduced or increased size. Sometimes there are also double heads. The types of shape deformations are as follows:

• pear-shaped;
• round;
• conical;
• flattened;
• asymmetrical arrangement.

Structural anomaly may be present not only in the head, but also in the neck or tail. If the neck of the gamete has irregular shape, the viability of the sperm is lost - he cannot actively move.

Important! The viability of the semen is determined by the sufficient number of sperm, their correct shape and vector of movement.

This pathology must be treated, since the anomaly will not be corrected by itself. But, as a rule, a man does not feel any symptoms of the disease and does not come to the doctor for an appointment. The presence of pathology is found out with unsuccessful attempts at conception.

What will the spermogram show?

When determining the causes of infertility in a couple, both spouses undergo diagnostics. The man is tested for spermogram. What is considered the norm? In the seminal fluid of a healthy man, deformed gametes may be present, but their number does not exceed the norm. If more than 50% of abnormal sperm are found, this indicates the pathology of the ejaculate.

In addition to abnormal spermatozoa, the ability to full-fledged conception is indicated by the normal volume of seminal fluid - at least 1 ml, and the activity of gum, and a sufficient number of necessary bodies. All this together determines the vitality and quality of the male seed.

However, a spermogram cannot always show a reliable picture of the causes of morphological disorders of gametes, therefore, other examinations are additionally prescribed:

• autoimmune test;
• semen analysis with washing;
• sperm vitality test;
• halo test and SDI test.

An autoimmune test detects antibodies that interfere with the attachment of gum to the egg. The wash test can be used to determine the cause of low sperm activity. The vitality test reveals the vitality of a man's sex cells and the ability to reproduce their own kind. The Halo test examines the presence of breaks in the DNA strand, the same is determined by the SDI test - but in a wider range of information.

Note! Sperm quality largely depends on the absence of congestion in the pelvic organs, so an active lifestyle contributes to the production of viable sperm.

Prior to the delivery of tests for ejaculate, the urologist conducts a comprehensive examination of the patient, which includes a bacterioscopic analysis of the semen, general analysis blood and ultrasound of the genitals.

What quality sperm should be? The norm is determined by Kruger and the WHO developments. The Kruger analysis sets more stringent standards for determining the viability of semen. For example, the Kruger test considers the presence of 14% of absolutely functional sperm to be the ideal norm. Anything that does not fit this standard is considered anomalous. The Kruger test examines sperm in all parts - in the shape of the head, neck and tail. WHO considers only the anomaly of the morphology of the head.

Spermogram according to Kruger

This is a spermogram with morphology that shows the pathology of the head. With this analysis, you can see:

• sperm shape;
• the nature of mobility;
• vector direction.

The analysis also shows the degree of sperm concentration, the viscosity of the semen and the acidic environment, the volume of ejaculate secreted at a time and its color. Is it enough once to determine all parameters? In practice, ejaculate is collected two or three times to obtain objective data.

Along with the Kruger analysis, a MAR test is performed to detect antibodies. If the result is positive, then there is a pathology. The interpretation of the analysis results is carried out by an experienced reproductologist according to the Kruger scale.

How to prepare for testing? Doctors require certain abstinence on the part of the patient:

• lack of sexual intercourse for the specified time (2-3 days);
• refusal to use any alcoholic beverages;
• refusal to visit the steam room and take hot baths.

How is the test going? The patient is offered masturbation in seclusion. The ejaculate must be collected in a sterile container and handed over to the laboratory assistant.

Analysis result

The reproductive specialist examines the seminal fluid under a microscope and draws conclusions about its condition. Morphological research involves the study of the structure and shape of sperm. Healthy sperm have a movable tail and an oval-shaped head. The direction of movement of the gum should be strictly straight, and not winding. The sperm count should be 15 million per milliliter.

Note! In the semen of any man, inactive spermatozoa are present, however, their number should not exceed the presence of motile and healthy ones.

How can abnormal zips prevent healthy ones from fertilizing an egg? They create an obstacle to their progress towards the goal.

What does a healthy sperm cell look like? It should have an oval head, a short neck and a sinuous tail. The structural parameters of the gamete are calculated according to a certain formula.

If the head does not have an acrosome, the sperm cannot dissolve the wall of the egg to enter. This pathology is called globozoospermia.

When the tails are separated from the head, the sperm cell loses its mobility - in this case, separate tails are found in the semen.

Sperm pathologies can be called differently:

• - the number of pathological sperm exceeds the permissible norm;
• akinozoospermia - lack of activity of gum;
• asthenozoospermia - low mobility of gum in the seminal fluid;
• - insufficient amount of sperm in semen.

Modern methods for the study of seminal fluid make it possible to determine not only the pathology of the head, but also anomalies in the morphology of the tails and necks.

Medication treatment

The course of therapy is aimed at eliminating the source of pathology. Since there are several sources of these, the treatment regimen for each patient is selected individually. If the pathology is caused by the presence of a focus of infection, a course of antibiotics is prescribed. Inflammatory processes are treated with anti-inflammatory drugs, hormonal disbalance- hormone therapy.

Varicocele can only be treated with surgery. After the elimination of venous dilatation, the quality of the sperm improves immediately. Together with the classic treatment, a course is prescribed vitamin preparations contributing to the restoration of sperm quality:

• folic acid contributes to the production of healthy sperm by the body;
• zinc preparations together with iodine provide sperm vitality.

Note! during treatment, it is unacceptable to consume alcoholic beverages, you also need to get rid of smoking.

Doctors forbid patients to visit saunas during treatment and engage in heavy physical labor. You cannot stay in a hot bath for a long time and otherwise raise your body temperature.

Diet

Proper diet also contributes to the quality of semen. The patient needs to exclude from the diet all fatty / canned foods, fried and smoked foods, any hard-to-digest food.

Products useful for sperm are:

• steam fish;
• different varieties of nuts;
• fresh herbs, seaweed;
• lean meats, liver.

Seafood is very beneficial for the formation of a quality semen composition. They contain all the necessary trace elements and proteins.

An active lifestyle

Remember, moderate activity throughout the day helps you stay healthy. If your job is sedentary, you need to find time for active movement.

For example, jogging, walking, swimming pool has a good effect on the activation of all vital forces of the body. If you don't have time to go to gyms, walk more often.

ethnoscience

Is it possible to cure the pathology of the head folk methods? Yes, spermatogenesis depends on the use of certain products, therefore, herbal treatment and the use of natural remedies help to correct defects in the formation of spermatozoa and charge them with vitality.

Healers recommend switching to herbal teas and using them instead of the usual black / green tea. For example, the quality of sperm is well influenced by the infusion of currant leaves - they can be dried independently in autumn and summer. Usually, after a month of treatment with currant tea, sperm is restored.

Note! Treatment with folk methods must first be discussed with a urologist or andrologist, because the causes of sperm pathology can be different.

Pumpkin porridge / juice helps the production of high-quality semen well. Herbal decoctions from nettle and birch leaves can also help correct the situation. To do this, dry leaves are mixed in equal proportions and stored in a wooden or paper container. To brew tea, you need to infuse a pinch of the mixture in boiling water for 25-26 minutes.

Apitherapy

Treatment with bee products has long been used in folk therapy. Honey has valuable biological substances that increase the immune status of a person. Besides, honey is a natural antibiotic and successfully fights many types of microorganisms.

For the treatment of sperm, it is proposed to use bee pollen and honey itself. You need to eat half a teaspoon (or one coffee) a day. Do not exceed the dosage so that an allergic reaction to an excess of biologically active substances does not develop!

Pregnancy with head pathology

Is there a chance of getting pregnant with incorrect sperm morphology? If this problem was discovered, you need to be patient - the treatment can take a long time, sometimes a year. In this case, doctors recommend going through the IVF procedure - artificial insemination.

Important! Abnormalities in sperm morphology are not a verdict for paternity. Modern medicine has effective methods artificial insemination.

A man donates sperm, under laboratory conditions a reproductive specialist selects the most viable spermatozoa and carries out in vitro fertilization. Then the embryo is transplanted into the woman's uterus for further development.

In addition to IVF, you can undergo the insemination procedure. During this procedure, sperm is injected into the woman's uterus using medical instruments - a tube. However, this technique does not always give a result in teratozoospermia, because pathologically altered sperm cells are not able to independently fertilize an egg.

Artificial insemination can be effective if there is a small morphological abnormality. The method ensures the entry of sperm into the uterus.

Outcome

The pathology of the sperm head has become a common problem in our time. There are a lot of factors contributing to the development of the disease: stress and physical overload, hereditary causes, a sedentary lifestyle, trauma to the pelvic organs and others.

This pathology is found after repeated unsuccessful attempts to conceive a child, since modern medicine examines both spouses together. About 20% of the male population of reproductive age is incapable of reproducing their own kind due to pathological changes in the morphology of sperm.

After the examination, it turns out what is the pathology of the head in the spermogram and the norm. Further, the patient is prescribed an individual treatment regimen, and methods of traditional medicine are not excluded. If the pathology is severely neglected, artificial insemination can be performed using the IVF protocol.

In the ovaries of men, starting from puberty, the processes of spermatogenesis continuously proceed. A huge amount of sperm is formed, some of which even normally contain certain defects and structural disorders. In the research form, they are indicated as pathological forms of spermatozoa. Let's take a look at the main characteristics and what can affect conception.

Macroscopic examination of sperm

The initial assessment of semen is done without the use of a microscope. Thus, you can evaluate:

1. Ejaculate dilution.

When semen is discharged from the urethra, it is runny. The secret of the seminal vesicles joins it, which gives its consistency a certain density. The secret of the prostate gland works in such a way that normally after 10-30 minutes the ejaculate is almost completely liquefied.

If after an hour sperm liquefaction has not occurred, then this may indicate a pathology of the prostate gland, which does not produce a sufficient amount of enzymes. Such a viscous consistency of sperm reduces the mobility of sperm, they practically do not move and during intercourse they will die in the vagina, never reaching the uterus and fallopian tubes.

Important! If the container with semen is shaken for a long time, spontaneous liquefaction of the ejaculate may occur. This should be taken into account by men who do not take the analysis in a laboratory. Do not shake the ejaculate container during transport, otherwise the results may be incorrect.

1. Viscosity.

How the viscosity is determined: a glass rod is dipped in the ejaculate and the length of the formed thread is measured. In addition, the viscosity can be determined with a wide base pipette. The ejaculate is drawn into a pipette and the length of the thread is measured with passive flow out of the pipette opening. Normally, the viscosity is not more than 20 mm. Increased viscosity is when the filament length is longer than the specified value.

The increased viscosity of sperm indicates that male germ cells cannot move normally in such sperm. They are immobile or inactive and, therefore, there is practically no chance of natural conception.

Important!Recent research indicates that increased viscosity may be associated with some infections of the urogenital tract in men.

1. Volume.

The spermogram is taken after 3-5 days of sexual abstinence. Under these conditions, the volume of sperm obtained should be in the range of 3-6 ml.

A decrease in sperm count may indicate:

• blockage or narrowing of the vas deferens;
• inflammation of the prostate;
• testicular disease;
• imbalance of hormones, etc.

A decrease in semen volume is called oligospermia, and its absence is called aspermia.

1. Blood in the ejaculate.

Blood (red blood cells) or its breakdown products give the semen a pink, brown or red hue. If the shade of the semen changes and blood is suspected, the ejaculate is examined using special test strips.

These test plates contain a special reagent. Erythrocytes or hemoglobin cause staining of the test area in a certain shade, which makes it possible to identify blood in the semen.

When there are red blood cells in the ejaculate:

• benign and malignant neoplasms this area;
• inflammation of the prostate and seminal vesicles;
• infections of the genitourinary system, etc.

Normally, there is no blood in the semen. Its presence in the ejaculate is called hemospermia. It can be false (with microtraumas) and true (with inflammation and tumors).

Important! Blood in semen is an alarming symptom that requires more research to find out the cause of the problem.

1. Leukocytes.

Normally, the semen may contain single neutrophils. With any inflammatory process, their number progressively increases.

This can be diagnosed by applying ejaculate to a test strip with a specific reagent. Upon contact with neutrophils, the color of this strip changes.

1. In addition, in the spermogram, the level of acidity (pH), the presence of bilirubin are checked, the color and smell are assessed. Some of these parameters have no diagnostic value (odor, color) and are performed as a tribute to traditional semen analysis.

Microscopic analysis

Sperm parameters are assessed under a microscope after liquefaction. It is performed in several stages. An apparatus with a special permission is required for the study. This study evaluates the following ejaculate parameters:

1. Sperm motility.

Male reproductive cells, depending on their mobility, are divided into 4 classes. According to the WHO criteria, the norm is the presence of more than 50% of sperm of classes A and B or more than 25% of class A.

1. Agglutination.

This is the process of gluing sperm together in different areas (tails, heads, etc.). This process should not be normal. The appearance of agglutination is associated with immunological reasons.

1. Aggregation (pseudoagglutination).

This is an accumulation of immobile sperm along with mucus and other pathological inclusions. This and the previous indicator is counted and recorded separately.

1. The presence of mucus.

Normally, there is no mucus in the spermogram. It appears in inflammatory processes in the testes, seminal glands and ducts. Mucus prevents sperm from moving normally, which leads to decreased motility and infertility.

1. Amyloid and lipoid bodies.

With the secretion of the prostate, various bodies (grains) enter the sperm: amyloid, lipoid (lecithin) and spermine crystals.

(or lecithin grains) are small shiny grains that are normally found in high numbers in semen. With inflammatory processes in the prostate, their number decreases or they disappear altogether. Lecithin grains (lipoid bodies) are an indicator of normal prostate function.

Amyloid bodies- round formations, the appearance of which may indicate chronic inflammation of the prostate.

These bodies can be viewed by performing special staining of the sperm under a high-resolution microscope.

1. Bacteria and protozoa.

Trichomonas can be seen under a microscope - these are round protozoa that cause trichomoniasis in humans.

Single cocci can normally be found in the spermogram. If their number grows and another microflora is found in the ejaculate (pyogenic cocci and anaerobes), this is a sign of an inflammatory process.

1. Macrophages.

Macrophages are large, round cells. Normally, macrophages are absent in semen. Single and multiple macrophages can be found in the ejaculate of patients with acute and chronic infectious diseases reproductive organs. When a patient develops macrophages in the ejaculate, he is first examined for latent urinary tract infections.

Sperm morphology

Male reproductive cells have a specific structure. The specialist knows how a particular area should look and what dimensions it should have. Any deviation from the norm is considered to be a pathological form of sperm. There are the following defects in male reproductive gametes:

1. Head defects.

The pathology of the head is different: disturbances in the shape of the head (pear-shaped, conical, etc.), problems with the size of the head (large or small), double and multiple heads, heads with an incorrectly positioned nucleus, heads with an acrosome abnormality, etc.

Male germ cells with head pathology according to WHO criteria and Kruger morphology are pathological forms that cannot fertilize an egg. Exceeding their number creates problems with conception and causes male infertility.

1. Neck and body defects.

Incorrect attachment, size or shape are all pathologies.

1. Tail pathology.

Short, long, doubled, widened, and other tail abnormalities prevent the sperm from moving normally and reaching the egg.

Questions to the doctor

Question: What are the “round cells” in the ejaculate?

Answer: Blood, cocci, epithelium, macrophages and others. All cells, except sperm cells, are collectively referred to as "round" cells.

Question: My husband's spermogram revealed cocci. After treatment of prostate inflammation, analysis showed single cocci. This is fine?

Answer: Single cocci can be in healthy semen. If multiple cocci, anaerobes and other microflora are found in the ejaculate, this is a sign of inflammation.

Question: How to correct lipoid bodies or lecithin grains

Answer: Lecithin grains are synonymous with the term lipoid bodies. These formations are contained in the secret of the prostate in large numbers. A decrease in their level indicates inflammation of the prostate gland.

Normal semen contains a number of abnormal forms of spermatozoa that can be detected after a semen analysis. It is important that the number of these forms does not exceed the established parameters and that there are no “harmful” inclusions in the semen. If a problem is found, additional tests are done and the cause of the disease is treated.

Sperm motility is the most important factor in fertility. Many couples face the problem of being unable to conceive. To establish the causes of childlessness, both partners must undergo a medical examination. The greatest attention is paid to the fertility of a woman, the composition and quality of a man's sperm. In the laboratory, the composition of the secretory fluid and the structure of the sperm are studied.

Sperm structure

The sperm cell has mobility due to its structure. Sperm consists of four divisions:

1. Top or head;
2. Neck or middle part;
3. Intermediate department;
4. Tail or flagellum.

The sperm cell is the male reproductive cell. Under the microscope, you can discern the rapid, chaotic movement of cells. Movements are in a circle, rectilinear and in place. For conception, sperm with straight motion... The rest of the cells are the total mass of the sperm.

The cell can move thanks to the tail. The flagellum contracts from the tip to the intermediate section and the cell moves. If there are any pathologies in the structure of the sperm, then the ability to move is lost.

Types of male germ cells

To study the state of cells, a man is assigned an analysis - a spermogram. The study is carried out on a liquid obtained within 20 minutes and having a body temperature. Before taking the analysis, a man must follow a number of rules:

Five days before taking a spermogram, a man must observe complete sexual rest. It is very important. The sperm composition will be concentrated and contain all types of sperm that are important for fertilization. If this rule is violated, then the analysis will be uninformative.

Beer and alcoholic beverages have a detrimental effect on ejaculate composition and sperm motility. Alcohol can completely kill cells and disrupt their production in the body. Abstinence from drinking alcoholic beverages must be at least 7 days. During this period of time, the sperm will have time to completely renew.

Before taking a spermogram, it is necessary to refuse to visit the bathhouse and sauna, to avoid prolonged hypothermia. When the temperature changes in the groin area, an instant death of the germ cells occurs. In some cases, the structure of the sperm may be disrupted.

Laboratory assistants distinguish several types of cells: A, B, C and D. The first type includes spermatozoa, which have the correct shape and move straight. Cells of the first type make up 25% of the total volume of semen. The second type includes normal cells that have poor forward mobility. The third type includes cells with a normal structure and good motility. But the movement of such sperm is circular. They are unable to reach the female egg in order to fertilize it. Type D includes all other types of sperm. Such cells may have an irregular structure, they may lack a tail or head, and they may be motionless. Sperm type D account for 15% of the total ejaculate volume.

All types of sex cells are always present in the semen of a man. The state of the sperm depends on the age of the cell and the hormonal background of the man. If the patient did not follow the rules for passing the tests, then the results obtained are not informative.

Semen classification

Semen can be composed of mobile, inactive cells. In some cases, sperm in the ejaculate is not detected.
Weak sperm motility is called asthenozoospermia. Pathology is classified into three grades.

Asthenozoospermia of the first degree is diagnosed when more than 50% of type B cells are present in the seminal fluid. Such a pathology is not considered dangerous and requires minor drug adjustments. Asthenozoospermia can occur with mild hypothermia, which has passed unnoticed by a man. If the analysis of the liquid was given in the winter, then this pathology is detected in many cases.

Asthenozoospermia of the second degree is detected if the liquid is 60–65% composed of inactive germ cells. With this pathology, damaged or mutated spermatozoa may be present in the ejaculate. The second degree of the disease requires medication. In 40% of patients with this disease, the cause of the mutation and cell death cannot be determined.

Asthenozoospermia of the third degree is the most dangerous form of pathology. Semen contains 70% or more of dead and inactive cells.

In order to count the number of sperm of each type, a special Goryaev camera is used in the laboratory. The seminal fluid is located on a glass, divided into squares. The initial research is carried out in four squares. The camera does the counting by itself different types cells. If there is not enough sperm in the square, then the microscopic field is increased to 9 squares.

Causes of pathology

Many factors affect sperm motility. They are classified into two types:

1. External reasons;
2. Internal.

Internal causes are present in all men. A decrease in the activity of germ cells may occur in patients suffering from diabetes mellitus or having insulin resistance. A disruption in the work of the patient's hormonal system leads to pathologies in the development and formation of germ cells. Testosterone levels directly affect the concentration of sperm in semen. The composition of the fluid is affected by the pathology of the genital organs. Especially often asthenozoospermia occurs if a man's testicles have not descended into the scrotal cavity. As a result of this pathology, the temperature balance is disturbed and sperm die.

The composition of the ejaculate depends on the age and body weight of the person. If you are overweight, a man may develop a disease in the area of ​​the seminal canal. This pathology disrupts the excretion of sperm, cell death occurs in the seminal canal. With increasing age of the patient, cell activity decreases. This pathology does not lend itself to drug therapy. Only hormonal drugs can improve the composition of the ejaculate.

Various infections are related to internal factors. Pathogenic microorganisms cause diseases of the human genitourinary system. The most dangerous microorganisms cause sexually transmitted diseases, in which the vital activity of spermatozoa is impossible. Treating infections leads to improved semen quality and condition.

External factors pose a danger to the composition of the ejaculate. Cell viability is affected by the abuse of beer or alcoholic beverages and smoking. Long-term studies have proven that sperm cells are intolerant to nicotine. Various injuries can damage the male reproductive system and completely exclude the ability to conceive. Prolonged nervous tension or depression leads to a decrease in the synthesis of the hormone, which affects the composition of the ejaculate.

Sperm motility can be affected by adverse magnetic radiation. V modern world there are tons of techniques. Mobile phones, microwave ovens, computers expose the human body to radiation. Microwaves disrupt the direction of movement of sperm, disrupt their production.

Treatment of pathologies of seminal fluid

There are several ways to improve the composition of your ejaculate. For the treatment of pathologies associated with the process of production and formation of sperm, three types of therapy are used:

1. Medicinal effects;
2. Medical massage;
3. Hardware therapy.

In many urological clinics, patients are offered a course of prostate massage. Men are very scrupulous about their health, but this procedure makes them shy. Do not take this therapy lightly. Direct massage of the prostate gland provides positive impact on the entire male reproductive system. Under the influence of massage movements, inflammation and edema from the prostate is removed. There is an acceleration of blood flow in the pelvic organs. The trophism of soft tissues is significantly improved. The procedure can reduce the phenomenon of prostatitis and normalize the production of hormones.

Apparatus therapy is just beginning to develop in Russian clinics. In pharmacies you can find a device for home use - "Mavit". The device helps to carry out magnetic therapy at home. Under the influence of magnetic waves in the prostate gland, the inflammatory process is removed, tissue nutrition is improved. In a man's body, the production of the hormone testosterone increases and the composition of the seminal fluid is normalized.

Drug therapy can completely restore sperm motility and improve the quality of the ejaculate. Medicines must be strictly prescribed by a doctor. It is forbidden to drink pills on your own, as the patient can seriously harm himself and worsen his health.
Many men are prescribed the drug - "Speman". The medicinal product consists of a complex of herbal components. The drug has a positive effect on prostatic hyperplasia, improves spermatogenesis, reduces the viscosity of the ejaculate. Long-term treatment contributes to the complete restoration of fertility in men. The drug is taken two pills twice. The drug "Spematon" is popular with doctors. The drug belongs to the group of vitamin preparations. "Spematon" is prescribed for young people planning a child and men suffering from infertility. The medicine contains daily rate vitamin E and other trace elements. The drug must be drunk before conception. The course can be 6 months.

For the treatment of male infertility, drugs from the group of amino acids are prescribed. Doctors prescribe a tablet preparation "Actovegin". The basis of the preparation is obtained from the blood of calves. The drug has a beneficial effect on the vascular nutrition of the prostate. Thanks to the active substance, the blood is saturated with oxygen, the trophism of the tissues is enhanced. Calf blood hemoderivative enhances cell metabolism. The energy capacity of the sperm increases. The body begins to produce spermatozoa that have a normal structure and a long period of vital activity. Doctors recommend taking the medication 1 tablet every 12 hours. The duration of treatment depends on the severity of the pathology.

In order to normalize sperm motility, a man must seek the help of a specialist and undergo a full course of treatment.