Man's examination
Spermiogram
Spermiogram is a basic method of diagnosis of male infertility. The basic indicators of ejaculate quality are – its volume, appearance, period of liquefaction, total number of sperms, percentage of movable sperms and percentage of morphologically normal sperms. The value of these parameters serves as an indicator for selection of the optimal method of the assisted reproduction (IUI, IVF, ICSI).
A sample of ejaculate is obtained by the man by means of masturbation in the collection room of the CAR; it is then immediately processed in the embryological laboratory.
The sample of sperm can be also be brought from home, but it is necessary to transport it into the CAR within 1 hour after the collection, in dark and at the body temperature, in a sterile vessel obtained at the CAR.
Basic categories of sperm quality:
- Normosperm - normal finding according to all the monitored criteria
- Oligozoosperm - concentration of sperms < 20x10 6/ml
- Asthenozoosperm - <50%sperms with a progressive motility of type a+b or <25% with a motility a
- Teratozoosperm - <30% sperms with a normal morphology
- Azoosperm - no sperms present in the ejaculate
- Asperm - absence of ejaculate
Sperm penetrating an oocyte |
Deformed sperm
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Urologic - andrologic examination – with the aim of clarification of the cause of the male infertility (infecundity)
Patient is asked about his anamnesis in a greater detail, with a focus on the diseases, which could have an impact on the patient’s fertility (mumps, injury of pelvis and medulla, feverish diseases, etc.)
Furthermore, an inseparable part is the examination of sperm and verification of number of sperms in the ejaculate (sperm is obtained by means of masturbation), examination of the hormonal profile of the patient (blood collection and determination of the level of gonadal hormones) or the cultivation examination of urine for exclusion of the uroinfection or the infection of prostate or seminal passages.
A physical examination also plays an essential part – i.e. examination of the abdomen, groins and external genitalia, and possibly a rectal examination (consideration of size and state of prostate). Additionally, a sonographic examination of the lower urinary passages and didymis is performed with an ultrasound probe by applying it on the hypogastrium or scrotum.
All the examinations, with the exception of the blood collection, are non-invasive and painless to the patient.