How to read a semen report, why talk about this topic? Because in the clinic, patients have many questions about semen reports and often ask, “Does this item have an effect? Can I get pregnant, how long will it take to get pregnant, is it normal, what if it is not normal? I would like to answer this question together with my male friends who have abnormal semen. First, what to look for, which items to look for in semen, and second, how to look and how to look at these results.
First, what do we look for in semen?
Nowadays, semen report forms often have dozens of parameters, 40, 50 or even more parameters, like our hospital labs, the analysis report form is 4. Generally speaking, although there are dozens of parameters, we clinically look at no more than 10 items at most.
1. Look at the amount of semen. The normal semen volume is 2 to 6 ml, if it is less than 2 ml, it means that the semen volume is a bit low, although the number of sperm per ml is a lot, but it is only half a ml, which is too little overall. Too little affects, too much will also be a problem, too much semen is diluted, also affects his fertility.
2. To see the appearance. What is the color of semen ejaculation? Under normal circumstances, men who have regular semen discharge should have milky white semen, and if they do not discharge for a long time, they should be somewhat yellowish. If the color of the semen is red, it is hematosperm, there is blood inside. If the semen is very yellow, it is not a long time to discharge semen, there may be inflammation and infection in the semen, there is pus inside, if the color of the semen is very yellow and thick, there are pus cells, there will be yellow semen. It is common to see these two kinds of semen. Generally speaking, this is the milky white color.
3, to look at the PH value. The normal pH value is 7.2 to 8.0, which is weakly alkaline, and most of the semen is between 7.4 and 8.0. If the pH value is acidic, for example, below 7.0, it often suggests problems with the seminal vesicles and prostate gland, but if it is too high, it also often suggests inflammation. This means that the PH value should be within a reasonable range, too acidic and too alkaline are not good.
4, look at the liquefaction of semen. Liquefaction is a very important parameter. Why does it liquefy? The seminal vesicle fluid contains substances that promote the coagulation of semen. The coagulation process is to protect the sperm, other debris can’t get in and the sperm can’t run out. Prostate fluid contains substances that promote liquefaction, hydrolytic protease, which can promote semen liquefaction. 15 to 20 minutes should liquefy, if it is not liquefied in more than half an hour, it may be a little delayed, and if it is not liquefied in more than an hour, it is not liquefied. Liquefaction is a very important indicator.
5, l 60 million, in 20 years ago 20 million can be, a year ago 15 million is enough, this degradation is mainly related to the environment, lifestyle. Now are sitting there, do not go to work in the fields, less labor, the original way of life changed.
6. Survival rate. In the past, it required more than 60%, the earliest required more than 70%, a year ago, the World Health Organization set a standard, more than 40% can be, the standard is getting lower and lower. The other is vitality, the ability of sperm activity, including fast linear motion, that is, the A class, and slow linear motion, that is, the B class. In the past, fast linear motion, A-class sperm greater than 25%, A + B greater than 35%, this is the standard a few years ago; a year ago A + B greater than 32% can be, this is the ability to move.
7. Look at the morphology of the sperm. The normal morphology requires more than 30%, then more than 15%, and a year ago the World Health Organization stipulated that a normal morphology of more than 4% is sufficient, and this standard is getting lower and lower.
At present, there are several kinds of hospitals in Beijing that test semen, some of them use computers to analyze semen, some of them are manual and look at it under a microscope, there are at least five kinds of test methods, the results are not uniform, in the case of computer analysis, some hospitals use the fifth edition, which is the latest standard, some hospitals still use the fourth edition, which is the original standard, so the whole semen situation is rather confusing.
Here’s how to look at these results
1. The quality of human semen fluctuates and is affected by many factors. For example, staying up late, sitting for a long time, having a fever, recent mental and mood problems, all have an impact on the quality of sperm, so even if the sperm can be fertile, its quality is not said to be the same every time you check. There is a famous experiment in which a man in the world checked his semen once a week for a year, 52 times, and made a trajectory chart. So for the semen changes, for example, a young man came, a check semen is not normal, must be abnormal? The World Health Organization stipulates that three consecutive checks should be made at intervals of three to seven days, some of which are more than a week, and in Chinese male doctors, basically not according to this, why? The Chinese patients are in a hurry, you ask him to come three times in a row, all day long is to check the semen, the patient is anxious, the patient is not satisfied, the doctor is also not satisfied, so in general, think that there is suspicion and then recheck once, no suspicion, first according to this treatment, and then after a period of time to check again. But sometimes there is a problem, for example, this time, the survival rate is 40%, two weeks after treatment, a check of 38%, how to cure down again, not as high as last time, I said it is a normal fluctuation, the patient does not quite understand. There is also a fluctuation of 50 million semen this time and 5 million next time. The first time the quality is poor, the patient is more satisfied with the high quality of the two weeks of treatment. So male friends must be clear, the quality of human semen is fluctuating, once is not easy to check accurate, need multiple times, generally speaking need three times, if two out of three times are normal, once is not normal, basically not a big problem. If two out of three times are normal and one is not, there is basically no problem. It’s not necessarily normal for people who can give birth normally to children to check now, so we need to look at this issue objectively and dialectically.
2. The uniformity of semen test results in different hospitals is relatively poor. As I said earlier, in Beijing, there are at least five methods of examination in hospitals, so it is understandable that the results are not good for comparison; but the examination methods are the same, and the results may not be the same, so why is this the case? Different hospitals laboratory quality control conditions, methods, laboratory technician technology, when taking semen, is the beginning of that point, or the back of that point, when looking at, this field of view and that field of view are very different. How to compare, in a hospital the same doctor examination, so that the results are comparable.
3, the credibility of some hospital examination reports is not high. Some patients go to the advertised hospital for laboratory tests, and when they look at the results are not good, is it impossible to have children? Later I said to review the test, in our hospital a check, completely normal. Different hospitals, one is not comparable, the second is the credibility is not high, the level of experiments, the level of the experimenter is poor, in addition is artificial.
4, different results, for different people, the meaning is not the same. The same semen quality is not good for a young man, and a 50-year-old man, his results may not have the same meaning, why the meaning is not the same? If a young man has a problem with his semen, it is too arbitrary to say that he must have a problem without a review. If you have a normal semen, you are not necessarily fertile. I once found that some women are prone to miscarriage, and the semen of the men were normal, but when they did the semen nucleoprotein test, they found that the nucleoprotein was not normal. Then we treated for a period of time, the sperm nucleoprotein was normal, and no more miscarriages. So if you are around 45 years old, have been married for a long time and have not yet gotten pregnant, and your semen is normal, but your fertility is not necessarily completely normal, it is time to firstly, review the test and secondly, to further investigate the cause. So semen examination means different things to different age groups and different people.
5. It is also easy to make a mistake if you do not consider the situation of your spouse. This semen was taken out and said you can’t get pregnant, but it turned out that you got pregnant later, and you said, “Director Li what’s going on! Is there something wrong with my wife? This time the wife is wronged, she does not have a problem, because the woman’s fertility, if strong, can make up for the lack of quality of male sperm. If a woman is in her 40s, her period is about to stop, and the quality of her sperm is normal, she may not be able to get pregnant for this reason: a 35-year-old woman has 50% of the fertility of a 25-year-old, 25% of a 38-year-old, 10% of a 40-year-old, and 5% of a 42-year-old, even if her period is still normal. So whether you can get pregnant or not, don’t say it must work or not, you must consider the situation of your spouse, without considering the situation of your spouse, it is easy to make a mistake in judgment.
Young people, whose semen are normal, can you tell which month you can conceive? In the case of half a year, only about 45%. With normal semen quality, you cannot accurately predict the time of ovulation. Sometimes patients are in the situation, is my semen normal, I say normal, grab a pregnancy; no, I’m going to get pregnant in a few months and have a baby in a few months next year, so I can have what genus ……
To sum up.
When you get a semen lab sheet, although there are dozens of parameters, we need to understand which parameters are the most important, its vitality, viability, malformations, etc., these are the more important parameters and we focus on these.
It is to judge objectively. Normal semen does not necessarily mean that you can get pregnant, it does not determine when you can get pregnant, it does not mean that you absolutely cannot get pregnant if it is not normal, it varies from hospital to hospital, it varies from lab technician to lab technician, it varies for the same person, at different points in time, his semen results, so semen report is a very complex issue. Therefore, for male friends, when you get a report, don’t be sad for abnormal and don’t be happy for normal, we have to consider many factors and make a comprehensive judgment.