WHAT IS SPERMATOBIOSCOPY? - MEDICINE - 2024

A spermatobioscopy is the evaluation of the ejaculated semen through a macroscopic and microscopic examination where certain aspects of it are analyzed. These aspects are the color, the volume, the viscosity, the alkalinity, the amount of sperm per millimeter, its mobility and the number of fully developed sperm in a man's semen.

In the process of reproduction in pairs, the female and male factors interact equally in importance. One or more alterations in any of these factors can cause sterility.

Because of these equally important functions, the gynecologist treating a patient who wishes to become pregnant must pay equal attention to the potential for pathology in the spouse.

In general, in 40% of cases the etiology is due to men, 40% to women, and in 20% of all cases it is shared by men and women.

In order to diagnose these diseases in men, a spermogram, also known as a spermatobioscopy, is performed.

Spermatobioscopy concept

As already mentioned, spermatobioscopy is a macroscopic and microscopic examination of the ejaculated semen, where the color, the quantity or volume, the viscosity, the alkalinity and, above all, and what is more important, the quantity of sperm per millimeter, their motility and the number of fully developed sperm are evaluated.

Therefore, spermatobioscopy is a qualitative and quantitative assessment of sperm fluid values. This laboratory test is a reliable method to evaluate the fertilizing capacity of the ejaculate.

When performing the analysis of the macroscopic properties of the sperm, the following parameters are taken into account: volume of the ejaculate obtained, color, liquefaction time, viscosity of the ejaculate and PH value.

When performing the microscopic analysis of the ejaculate, the following properties of the cellular elements are determined: number of sperm cells and their motility, morphological properties of the sperm, presence of immature forms and number of white blood cells.

Spermatobioscopy results

The World Health Organization, along with most of the international organizations that guide the medical field in human reproduction, have agreed to use the term "normozoospermia" to indicate normal test results.

Oligozoospermia is indicated in test results with a sperm count less than 20 million per ml or 60 million in total count.

Whereas "aspermia" or "azoospermia" refer to a condition where there is no sperm in the sample.

For its part, "teratozoospermia" refers to the abnormally abundant sperm and "asthenozoopermia" to the presence of considerable alterations in sperm motility.

Lastly, "oligoastenozoospermia" refers to alterations in the number and motility of sperm in the sample.

Possible treatments after spermatobioscopy

Oligozoospermia and asthenozoospermia are the most common disorders found in male infertility. Its study and treatment is somewhat difficult due to the complexity in determining the precise etiology.

The origin can be secretory, or in cases where there are alterations in spermatogenesis. On the other hand, these conditions can be caused by an excretory factor, caused by the obstruction of a segment of the seminal tract can be the culprit.

There may also be a mixture of both secretory and excretory causes. In more exceptional cases there are mechanical causes, as in retrograde ejaculation.

Azoospermia has a cautious prognosis, except in cases that respond to hormone treatment.

The absence of sperm, due to obstruction in any part of the seminal tract, is treated with surgery in most cases. Another option is the collection of sperm for its application in assisted reproduction techniques.

Asthenozoospermia is usually secondary to acute or chronic infections, acute or chronic trauma to the testicles, and environmental trauma when there is prolonged exposure to heat and chemicals.

Spermatobioscopy analysis

For accurate results, it is recommended to avoid ejaculation, alcohol, caffeine, and any herbal or hormone medications for 3-5 days prior to testing.

The evaluation of the concentration of sperm cells and the analysis of their motility is carried out by analyzing the video clips captured in the memory of the laboratory computer.

This test also allows to evaluate the morphological properties: shape of the head, neck and tail of the sperm cell.

The normal parameters according to the criteria of the World Health Organization are the following:

• Volume = 1.5 ml
• Overall sperm count = 39 mln
• Sperm concentration = 15 mln / ml
• Mobility = 40%
• Progressive motility = 32%
• Viability = 58%
• Morphology = 4%
• Acid-base balance of semen (pH) = 7.2

A more specific parameter is the degree of motility, where the motility of the sperm is divided into four different degrees:

• Grade A or Motility IV: progressively motile sperm. These are the strongest and fastest, they swim in a straight line.
• Grade B or Motility III: (Nonlinear Motility): These also move fast but tend to travel in a curved or twisted motion.
• Grade co motility II: these have non-progressive motility because they do not advance despite wagging their tails.
• Motility Grade I: These are immobile and do not move at all.

Sperm cell morphology is an important criterion for establishing a correct diagnosis.

Increased number of morphologically abnormal sperm cells in the ejaculate is one of the most common causes of male infertility.

Factors influencing the results

In addition to the quality of the semen itself, there are several methodological factors that can influence the results, leading to variations between methods.

Compared to samples obtained from masturbation, semen samples from special condoms for collection have higher total sperm counts, sperm motility, and percentage of sperm with normal morphology.

For this reason, these condoms are believed to give more accurate results when used for semen analysis.

The results of this test can have a great deal of natural variation over time, which means that a single sample may not be representative of the characteristics of a man's average semen.

It is believed that the stress of producing an ejaculation sample for examination, often in an unfamiliar environment and without lubrication (most lubricants are somewhat harmful to sperm), may explain why the first samples of men, a they often show poor results.

References

1. Arenas ML. Sperm's function in reproduction. Recovered from: iech.com.
2. Hinting A, Schoonjans F, Comhaire F. Validation of a single-step procedure for the objective assessment of sperm motility characteristics (1988). International Journal of Andrology.
3. Irvine DS. Computer assisted semen analysis systems: sperm motility assessment (1995). Human reproduction.
4. Irvine DS, Aitken RJ. Seminal fluid analysis and sperm function testing (1994). Endocrinology & Metabolism Clinics of North America.
5. Rothmann SA, Bort AM, Quigley J, Pillow R. Sperm morphology classification: a rational method for schemes adopted by the world health organization (2013). Clifton: Methods in molecular biology.
6. Weschler T. Taking charge of your fertility (2002). New York: Harper Collins.
7. Undestanding Semen Analysis (1999). Recovered from: web.archive.org.