Everyone knows the problem: in clinics and doctors' surgeries, it seems as if a completely different language is being spoken. This mixture of Latin and Greek makes the doctors sound more competent, but confuses everyone else. Especially when you receive a letter with some results, you're probably a bit perplexed, especially as you probably don't have anyone at home to translate the terms. In fertility treatment, this is particularly the case with spermiograms. These are made up of many different parameters with corresponding reference values. To help you make sense of your results, we are going to explain the different terms and standard values.

The spermiogram

The spermiogram itself is an examination of all the sperm in the laboratory. A sample is usually taken at the doctor's surgery and then sent to the laboratory. In most cases where this is done, it is because of fertility problems. The results can be used to make statements about the patient's fertility. Among other things, the sperm can also be tested for inflammation. The results are compared with standard values. These are an average of many samples from healthy patients who have already been tested.

Ejaculate parameters

When it comes to the parameters to be examined, the first thing that naturally comes to mind is sperm. They play an important role in fertility testing and are assessed for number, appearance and motility. However, the remaining fluid is also examined. It is the transport medium for the sperm and contains the necessary nutrients. If the environmental conditions are poor, the quality of the sperm will also be affected, even though the sperm themselves are fine. This is why the pH is also measured during the spermiogram. As the ejaculate is slightly alkaline, the value should be between 7 and 8. The fructose level is also very important, as this is what the sperm feed on. Its value should be at least 13 µmol, although a slightly higher value is not so bad to begin with.

In addition to the expected parameters, the sperm may also contain leukocytes. These are white blood cells that are part of the immune system. It is also possible that the individual cell types are listed on your report, in which case the so-called neutrophils are usually the problem. These cells are always present in the body, but there should not be more than 1 million cells per millilitre in the ejaculate. If this is exceeded, it indicates an inflammatory response. This is usually due to an infection, such as a sexually transmitted disease or a urinary tract infection. Such findings must always be investigated further before continuing with fertility treatment.

Before analysing all the individual parameters, the volume of the total ejaculate must also be measured. It is therefore important to make sure that everything is collected in the cup. The normal volume is at least 1.5ml.

Possible results of the semen analysis

Oligospermia

If you see the prefix 'oligo' before something, it always means there are too few of them. In oligozoospermia, the ejaculate contains too few sperm. In normozoospermia, i.e. a healthy man, the ejaculate contains at least 39 million individual sperm, but in oligozoospermia there are considerably fewer. Oligozoospermia does not indicate whether these sperm are functional or whether their genetic material is intact. Men with oligozoospermia are not necessarily unable to become pregnant, but their chances are reduced.

Azoospermia

While in oligozoospermia the sperm count is reduced, in azoospermia the ejaculate contains no or very few sperm. It consists only of seminal fluid. There can be several reasons for this. Firstly, the production of sperm in the testicles may be disturbed, usually for hormonal reasons. The vas deferens may also be blocked, in which case surgery can help. There is a transitional form between oligospermia and azoospermia called cryptozoospermia.

Aspermia

As we have just seen, the prefix 'A-' means that something is missing. In the case of aspergillosis, no sperm are produced at all. However, this type of infertility is usually treated before trying to have a child.

Asthenozoospermia

Asthenozoospermia is reduced sperm motility. It is when less than 40% of sperm are motile or less than 32% of sperm are fast motile (WHO). Sperm need to be motile to travel through the uterus to the ovaries, and in asthenozoospermia they cannot do this. It is very easy to get around this problem by removing the sperm and transferring them directly to the egg using ICSI or IVF. However, the couple may still be lucky enough to become pregnant without artificial help, as the partner's fertility is limited.

Necrozoospermia

The more serious form of asthenozoospermia is called necrozoospermia. "Necro means dead, so the sperm cells are dead and do not move. The dead cells are no longer capable of fertilisation, so IVF with such sperm would have little effect. In this case, the partner is usually very infertile.

Teratospermia

Teratospermia is the presence of irregularly shaped spermatozoa. In medicine, this phenomenon is usually referred to as pathological morphology. Teratospermia is considered pathological when less than 30% of the sperm in the sample are normally shaped. Teratospermia is often associated with asthenozoospermia, as it may be the cause of the latter.

MAR -Test

The Mixed Antibody Reaction Test, or MAR test for short, is also often carried out during a spermiogram. It detects autoantibodies in the sperm. Autoantibodies are part of the body's immune response to its own cells, in this case mostly to the sperm itself. As a result, the sperm are attacked and at least partially destroyed. This limits their function. In principle, autoimmune diseases can occur in any person at any time, but if an immune disease has already been diagnosed elsewhere, the likelihood of another reaction of this kind is increased.

In general, it is important to know that most of the conditions described do not occur in isolation. Many people have two or three of them at the same time. This gives rise to metre-long medical terms such as oligoasthenoteratozoospermia. Don't let this confuse you, because medical terms can be put together - and taken apart - like building blocks. If you get stuck, even with the help of the internet, you can always contact your doctor and have everything explained to you again in detail.