After the New Year’s Day, Mr. Liu was ready to add a tiger cub to himself in the Year of the Tiger, as he had planned before. In order to be able to “eugenics”, two weeks ago Mr. Liu, who has been “resting up” for 10 days, came to the hospital with his wife to have a semen examination. After waiting patiently for more than an hour, Mr. Liu, who got the semen report, was dumbfounded: sperm density 18×106/ml, viability 71.3%, semen leukocytes 0.6×106/ml, normal sperm form 32% (68% malformation rate), and positive seminal plasma fructose. In particular, such a high malformation rate and positive fructose caused him to decide that he had lost his ability to have children and fell into deep distress —— Here, we briefly introduce to you the self-readings of semen reports according to the relevant contents of the WHO Laboratory Test Manual for Human Semen and Sperm-Cervical Mucus Interaction (4th edition) to clear Mr. Liu’s doubts. At present, the commonly used method for routine semen testing is computer assisted sperm analysis (CASA), which is the analysis of sperm count and activity by computer software after identifying sperm through a microscope. A typical CASA report includes items such as semen volume, color, viscosity, liquefaction, pH and sperm density, motility and viability. Units with good conditions further carry out tests for sperm morphology, anti-sperm antibodies, bacterial culture, seminal plasma biochemistry and other items. The first thing to check after getting the semen report is your name, age and whether the number of days of abstinence is in line with the real situation, the number of days of abstinence is generally required to be 2 to 7 days, too long will “smother” the sperm and lead to reduced mobility, and will not necessarily produce the “sperm accumulation” that many people believe. This does not necessarily produce the “sperm accumulation” that many people believe. Next, you can see some “general trait tests”. These include visual observation of the color, consistency and liquefaction time of semen, measuring the volume of semen with a measuring cylinder, and testing the pH of semen with pH paper. Normally, the volume of semen is 2 to 6 ml, but if it is less than 1 ml, the volume of semen is too small. This is often due to short abstinence days, reproductive tract infection or obstruction of the vas deferens. It is not good if the semen volume is too much (more than 8m1 at a time), as the total number of sperm will be diluted, which will also affect fertility, and this is often seen in cases of prolonged abstinence or hyperactive accessory gonads. The color of normal semen is usually milky white or grayish white. If abstinence is prolonged, the color may be yellowish. Some people may suddenly have bright red, dark red or coffee-colored semen, which is called “hematosperm”. It may be due to rupture of the capillaries of the seminal vesicles or infection of the reproductive tract, but further examination is needed to rule out malignant disease. In terms of acidity, normal semen is weakly alkaline (pH 7.2-7.8). If the semen is too acidic (pH <7.0), it may be due to failure to discharge alkaline semen from the seminal vesicles, such as obstruction of the ejaculatory ducts or congenital seminal vesicle defects; if the pH is >8.0, there may be an acute reproductive tract infection, and further semen leukocyte examination is required to confirm the diagnosis. Generally, normal fresh semen is viscous and jelly-like after discharge and needs to be incubated in a water bath (37°C) until it is completely liquefied before it can be tested, usually within 30 minutes. If you see a report showing liquefaction time greater than 1 hour, it indicates that the semen is not liquefied, which is an important cause of obstructed sperm activity, like a person swimming in a mud puddle. This condition is mostly caused by infections such as inflammation of the prostate gland. If the consistency decreases or the semen does not clot, it indicates the possibility of reproductive tract infection. In the subsequent “microscopy report”, we can see the results of sperm density, motility, viability and sperm morphology. The normal sperm density is greater than or equal to 20 x 106/ml, and if it is too low, it is called oligospermia. There are many possible causes of low sperm density, such as impaired testicular sperm production, partial obstruction of the reproductive tract, short abstinence days or incomplete semen collection (many patients may The first part of the semen is ejaculated outside the sperm cup, which is the part with the highest sperm density). It is important to mention the concept of azoospermia, which is different from azoospermia, where the patient has the sensation of ejaculation but no semen is emitted. The diagnosis of azoospermia, on the other hand, must be finalized after three or more semen centrifugations followed by sediment examination in which no sperm is found. The most common causes are congenital testicular hypoplasia, acquired testicular damage or atrophy or obstruction of the reproductive tract. With normal sperm density, good sperm motility is also required, and WHO recommends that sperm motility be classified into 4 classes: Class A sperm have good motility, rapid movement and straight forward motion; Class B sperm have good motility, moderate speed, variable swimming direction, straight or non-straight motion; Class C sperm have poor motility, sluggish movement, spinning or jittering in place, and poor forward motion; Class D sperm are completely inactive or slightly jittering. Class D sperm are completely inactive or slightly jittering. Normally, Class A motile sperm >25% or Class A+B motile sperm >50%. If the sperm motility alone is low, it is weak spermatozoa, mainly seen in varicocele and urogenital tract infection. Adding up the percentages of class A, B and C sperm is the overall percentage of motile sperm, also called sperm viability. Normally the viability should be above 70%, but it also needs to be analyzed together with sperm viability. Sperm morphology is another indicator that often bothers patients. Many people worry that malformed sperm can cause fetal malformations, but in fact there is no direct relationship between the two. According to the standard, a sperm count of more than 30% of normal morphology is considered normal. However, there are still many patients who are overly sensitive to the malformation rate of sperm and still feel that there is a problem even if it exceeds 30%. As mentioned before, reproductive tract infections require semen leukocyte testing to finally confirm the diagnosis. Under normal circumstances, the number of leukocytes in semen should be less than <1.0×106/ml, and if the number increases, it indicates reproductive tract infection. The development of a real reproductive tract infection. And Mr. Zhang has been nagging seminal plasma fructose, positive is the normal situation. Sperm plasma fructose metabolism provides energy for sperm movement and is essential for sperm movement and subsequent energy replenishment. At the same time, seminal plasma fructose mainly originates from the seminal vesicles. If the qualitative test for fructose is negative (i.e., absent), there is often no sperm in the semen and the seminal vesicles are considered to be not ejaculated, and there may be obstruction of the ejaculatory ducts or absence of seminal vesicles. After reading the above simple explanation, Mr. Zhang should be able to have some understanding of his semen condition. However, we also need to remind readers here that (1) one semen test may not accurately reflect the semen condition, and at least 2 tests are needed; (2) there are fluctuations in the semen condition, and two tests may differ greatly; (3) there are many factors affecting semen quality, which can also be caused by misunderstandings of patients such as days of abstinence and incomplete ejaculation; (4) even if there is really a problem with semen quality, it does not mean loss of fertility, but only a relative decrease in the probability of conception, and the final fertility situation requires a comprehensive judgment by the clinician.