Nowadays, more and more newlyweds are paying attention to the preparation before pregnancy, adjusting their bodies to an optimal condition and performing some necessary physical examinations before preparing to conceive a little life. However, having a BABY is not a matter for the wife alone, but requires the cooperation and efforts of both spouses. There are some pre-conception examinations that require both men and women. The woman’s examination will be more, while the man’s examination is relatively simple, semen examination is one of them. Expectant fathers, is your “seed” good?
Semen examination is an important basis for analyzing male fertility. Therefore, during the pre-conception checkups and treatment of male infertility patients, the doctor should first ask him to undergo a semen examination. The results of semen examination are important not only for male doctors, but also for obstetricians and gynecologists. When it is clear that the male partner is suffering from infertility after semen examination, many tedious tests for the wife can be avoided and treatment can be carried out in a timely manner.
The semen is a grayish-white liquid composed mainly of secretions from the testicles, epididymis, prostate and seminal vesicles, and a small amount of secretions from the urethral glands. Spermatozoa are the most important organic component of semen, accounting for 5% to 10%.
Spermatozoa develop gradually from the spermatogonia in the testes, and the entire development cycle takes about 74 days. Adult men can produce about 100 million sperm per day. Changes in body condition, external stimuli (e.g. radiation, temperature), etc., can only change the quality of sperm, but not its developmental cycle. The liquid component is called seminal plasma, which is the necessary medium to transport sperm, of which seminal vesicle secretion accounts for 60% to 70% and prostate fluid accounts for 20% to 30%. The specific contents of semen examination So how to perform semen examination?
What exactly is the content of semen examination?
The first thing you need to do is to collect your own semen for the semen test.
2, in the semen collection requires the subject to abstain from sex for 3 to 5 days, if the time is too short or too long will affect the test results.
3, Using masturbation or in vitro ejaculation, collect all semen in a clean container, store it in an environment close to body temperature (such as under close underwear) and send it to the laboratory for examination as soon as possible, no later than 1 hour.
4. Condoms should not be used for preservation because the condoms normally used contain spermicidal substances that can cause sperm death. Routine semen examination Routine examination is the most important part of semen examination, which generally includes semen color, semen volume, semen liquefaction time, sperm density, sperm survival rate in 1 hour, sperm vitality, percentage of deformed sperm, and white blood cell count in semen.
The color of normal semen is transparent and grayish white. If the abstinence time is long, it may be yellowish, and if there is inflammation in the reproductive tract, it may be yellow or even have blood in the semen. The volume of semen is 2ml to 6ml per discharge, but it is affected by the frequency and number of discharges.
Semen volume less than 1ml/time is called reduced semen volume, and semen volume more than 6ml/time is called excessive semen volume, which are abnormal conditions. Semen liquefaction time Semen is in a gel state when it is first discharged from the body, and will turn into a liquid state after 5 to 30 minutes, a process called liquefaction. The liquefaction of semen requires the participation of a series of protein hydrolases. Sticky and non-liquefied semen is commonly found in patients with prostate or seminal vesicle diseases. Semen is weakly alkaline, with a pH between 7.2 and 7.8. If pH <7, it is acidic, and if pH >8, it is alkaline, both of which can limit sperm function.
Sperm density refers to the number of sperm contained in each ml of semen. The normal number of sperm in each ml of semen is more than 20 million, if less than 20 million/ml is oligospermia, it will affect fertility. Sperm survival rate in 1 hour The percentage of active sperm within 1 hour after sperm discharge should be not less than 60%.
Sperm vitality Sperm vitality is divided into four grades: Grade A – fast straight forward movement Grade B – slow forward movement Grade C – oscillation in place Grade D – inactive -inactive Normal sperm vitality, not less than 25% for grade A or not less than 50% for grade A+B. If it is lower than normal, it is considered low sperm vitality. It should be noted that inactive sperm does not mean dead sperm, it may still be alive but with loss of motility. Eosin staining is commonly used to determine if the sperm is dead.
The percentage of deformed sperm refers to abnormal morphology of sperm, which should be below 30%. If the abnormality rate exceeds 30%, it is abnormal and may affect fertility. The number of white blood cells in semen The number of white blood cells in semen should be less than 5 per high-powered view normally, if it exceeds 5, there is a possibility of inflammation of the reproductive tract.
Infection in the male reproductive system can cause changes in semen quality, such as semen volume, semen pH, liquefaction time and sperm survival rate. There are more than 30 pathogenic microorganisms that cause infections, such as Staphylococcus, Escherichia coli, Enterococcus, Mycoplasma, Chlamydia, etc. Semen infections may be an important cause of male infertility.
Therefore, in case of abnormal semen examination, it is necessary to perform semen bacteriological examination to help diagnosis and treatment. When bacteriological examination is required, semen specimens should be collected in sterile cups. Semen biochemistry tests In hospitals that are able to do so, the doctor will also have the patient undergo a semen biochemistry test. The biochemical examination of semen is an easy way to determine the secretory function of the accessory gland.
It includes fructose, zinc, acid phosphatase and carnitine. Fructose mainly comes from the seminal vesicle gland and provides the energy needed for sperm activity. The absence of fructose or reduced fructose content is seen in congenital seminal vesicle deficiency and seminal vesicle inflammation, etc. It is not easy to make the wife conceive when fructose is insufficient.
The prostate contains high concentrations of zinc and acid phosphatase, and the epididymis has high concentrations of carnitine, which are all related to sperm function, and when inflammation occurs in the prostate and epididymis, their levels are reduced, thus affecting fertility. Factors affecting semen examination Semen examination is sometimes affected by a number of factors, such as too short or too long abstinence, recent physical fatigue, recent heavy drinking and smoking, recent fever, leakage of some semen during sperm collection, poor environment during sperm collection, and failure to send semen for examination in time after collection.
All these factors may make the test results inaccurate. Therefore, when the results of one examination are abnormal, it cannot be assumed that there must be a problem. Generally, the examination should be repeated 2 to 3 times at intervals of 1 to 2 weeks. Only with multiple examinations will semen abnormalities have clinical significance. Semen examination results and determination of infertility Based on the semen examination results, the doctor will determine whether the person being examined is suffering from infertility.
According to the semen examination results, infertility can be classified as
1. Oligospermia: sperm density below 20 million/ml.
2. Azoospermia: no sperm found in semen after centrifugal sedimentation for 3 times of examination.
3.Low sperm vitality.
4, dead spermatozoa: the majority or all of the sperm in the semen are dead sperm.
5.Seminal fluid non-liquefaction disorder. The doctor will then understand the exact cause of infertility (such as endocrine diseases, reproductive tract infections, positive anti-sperm antibodies, varicocele, sexual dysfunction, etc.) based on other aspects of the examination performed on the infertility patient, including physical examination, blood tests, etc., in order to take appropriate treatment measures to improve semen quality and restore fertility.
The current treatments for male infertility include endocrine hormone therapy, antibiotic therapy to control inflammation in the reproductive tract, immune infertility (positive anti-sperm antibodies) therapy, general therapy (vitamins, zinc, energy preparations, etc.), herbal therapy, assisted reproductive technology and surgical treatment. All these treatments are needed on the basis of the semen test results.